{"hospital_name":"HCA FLORIDA CITRUS HOSPITAL","last_updated_on":"2024-10-01","version":"2.2.0","affirmation":{"affirmation":"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.","confirm_affirmation":true},"hospital_location":["HCA FLORIDA CITRUS HOSPITAL"],"hospital_address":["502 W Highland Blvd, Inverness, FL, 34452"],"license_information":{"hospital_license_number":"4233","state":"FL"},"standard_charge_information":[{"description":" Behavioral Health Treatment/Services Intensive Outpatient Services - Psychiatric  ","code_information":[{"code":"905","type":"RC"}],"standard_charges":[{"setting":"outpatient","minimum":199.00,"maximum":515.00,"payers_information":[{"payer_name":"Aetna Better Health","plan_name":"HEALTHYKIDS","standard_charge_dollar":225.00,"methodology":"case rate"},{"payer_name":"Aetna Better Health","plan_name":"MCD","standard_charge_dollar":225.00,"methodology":"case rate"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_dollar":341.00,"methodology":"per diem"},{"payer_name":"Beacon Health Options","plan_name":"MCR","standard_charge_dollar":276.00,"methodology":"per diem"},{"payer_name":"Beacon Health Strategies","plan_name":"MCD","standard_charge_dollar":200.00,"methodology":"per diem"},{"payer_name":"Beacon Health Strategies","plan_name":"MCR","standard_charge_dollar":200.00,"methodology":"per diem"},{"payer_name":"CareSource","plan_name":"HealthyKids","standard_charge_dollar":299.00,"methodology":"case rate"},{"payer_name":"CareSource","plan_name":"MGMCD","standard_charge_dollar":199.00,"methodology":"case rate"},{"payer_name":"Carisk Behavioral Health","plan_name":"COMM","standard_charge_dollar":279.00,"methodology":"per diem"},{"payer_name":"Magellan Health","plan_name":"COMM","standard_charge_dollar":515.00,"methodology":"per diem"},{"payer_name":"Magellan Health","plan_name":"MCR","standard_charge_dollar":515.00,"methodology":"per diem"},{"payer_name":"New Directions Behavioral","plan_name":"COMM","standard_charge_dollar":460.00,"methodology":"case rate"},{"payer_name":"New Directions Behavioral","plan_name":"MCR","standard_charge_dollar":460.00,"methodology":"case rate"},{"payer_name":"S FLORIDA COMMUNITY CARE","plan_name":"HealthyKids","standard_charge_dollar":299.00,"methodology":"case rate"},{"payer_name":"S FLORIDA COMMUNITY CARE","plan_name":"MGMCD","standard_charge_dollar":199.00,"methodology":"case rate"},{"payer_name":"Sunshine State","plan_name":"MGMCD","standard_charge_dollar":199.00,"methodology":"per diem"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":226.00,"methodology":"per diem"},{"payer_name":"United Behavioral Health","plan_name":"COMM","standard_charge_dollar":417.00,"methodology":"per diem"},{"payer_name":"United Behavioral Health","plan_name":"MGMCD","standard_charge_dollar":297.00,"methodology":"per diem"},{"payer_name":"United Behavioral Health","plan_name":"MGMCR","standard_charge_dollar":363.00,"methodology":"per diem"}]}]},{"description":" Room & Board - Semi-private (Two Beds) Detoxification  ","code_information":[{"code":"126","type":"RC"}],"standard_charges":[{"setting":"inpatient","minimum":850.00,"maximum":76345.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":850.00,"methodology":"per diem"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_dollar":1136.00,"methodology":"per diem"},{"payer_name":"Beacon Health Options","plan_name":"MCR","standard_charge_dollar":1103.00,"methodology":"per diem"},{"payer_name":"Beacon Health Strategies","plan_name":"MCD","standard_charge_dollar":1018.00,"methodology":"per diem"},{"payer_name":"Beacon Health Strategies","plan_name":"MCR","standard_charge_dollar":1018.00,"methodology":"per diem"},{"payer_name":"Carisk Behavioral Health","plan_name":"COMM","standard_charge_dollar":1106.00,"methodology":"per diem"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":2940.00,"methodology":"per diem"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":3516.00,"methodology":"per diem"},{"payer_name":"CorVel Corporation","plan_name":"WORKERSCOMP","standard_charge_dollar":6650.00,"methodology":"fee schedule"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":850.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":76345.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":76345.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":850.00,"methodology":"per diem"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":850.00,"methodology":"per diem"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":850.00,"methodology":"per diem"},{"payer_name":"Rockport Healthcare Group","plan_name":"WORKERSCOMP","standard_charge_dollar":7000.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":1040.00,"methodology":"per diem"}]}]},{"description":" Emergency Room ER Beyond EMTALA  ","code_information":[{"code":"452","type":"RC"}],"standard_charges":[{"setting":"outpatient","minimum":735.00,"maximum":5635.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":821.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":3449.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":3449.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_dollar":1918.00,"methodology":"case rate"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":895.00,"methodology":"case rate"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":895.00,"methodology":"case rate"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":825.00,"methodology":"case rate"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":895.00,"methodology":"case rate"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":895.00,"methodology":"case rate"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":977.00,"methodology":"case rate"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":900.00,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":5635.00,"methodology":"case rate"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":960.00,"methodology":"case rate"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":985.00,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":5635.00,"methodology":"case rate"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":800.00,"methodology":"case rate"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":800.00,"methodology":"case rate"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":977.00,"methodology":"case rate"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":977.00,"methodology":"case rate"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":977.00,"methodology":"case rate"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":795.00,"methodology":"case rate"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":735.00,"methodology":"case rate"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":1400.00,"methodology":"case rate"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":4000.00,"methodology":"case rate"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":985.00,"methodology":"case rate"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":750.00,"methodology":"case rate"}]}]},{"description":"ABORTION WITHOUT D&C ","code_information":[{"code":"779","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":23825.50,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":8431.88,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8516.20,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":9190.75,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8937.80,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":3171.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":4418.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":3171.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8516.20,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8516.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":4668.82,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":11253.06,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":4668.82,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":3171.55,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":9275.07,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":14915.94,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":23825.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8937.80,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":9190.75,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":8431.88,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":9190.75,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8356.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8178.93,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":8937.80,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10539.85,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":8431.88,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":8431.88,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":8431.88,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7942.15,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9401.55,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8431.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":8060.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8431.88,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":8431.88,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8263.25,"methodology":"fee schedule"}]}]},{"description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each ","code_information":[{"code":"A4342","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":815.44,"maximum":924.73,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":840.66,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":899.51,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":891.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":857.47,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":857.47,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":924.73,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":899.51,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":924.73,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":899.51,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":916.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":840.66,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":924.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":882.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":815.44,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":840.66,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":882.69,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":857.47,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":840.66,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":840.66,"methodology":"fee schedule"}]}]},{"description":"ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ","code_information":[{"code":"80402","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":78.82,"maximum":103.48,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":86.96,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":93.05,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":92.18,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":88.70,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":88.70,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":95.66,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":93.05,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":95.66,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":93.05,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":94.79,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":86.96,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":95.66,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":91.31,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":78.82,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":86.96,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":103.48,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":91.31,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":88.70,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":86.96,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":86.96,"methodology":"fee schedule"}]}]},{"description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions ","code_information":[{"code":"L1085","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":209.41,"maximum":237.48,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":215.89,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":231.00,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":228.84,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":220.21,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":220.21,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":237.48,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":231.00,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":237.48,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":231.00,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":235.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":215.89,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":237.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":226.68,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":209.41,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":215.89,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":226.68,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":220.21,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":215.89,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":215.89,"methodology":"fee schedule"}]}]},{"description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather ","code_information":[{"code":"L1100","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":172.68,"maximum":195.82,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":178.02,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":190.48,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":188.70,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":181.58,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":181.58,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":195.82,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":190.48,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":195.82,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":190.48,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":194.04,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":178.02,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":195.82,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":186.92,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":172.68,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":178.02,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":186.92,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":181.58,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":178.02,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":178.02,"methodology":"fee schedule"}]}]},{"description":"Addition to ctlso or scoliosis orthosis, thoracic pad ","code_information":[{"code":"L1060","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":106.40,"maximum":120.66,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":109.69,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":117.37,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":116.27,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":111.88,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":111.88,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":120.66,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":117.37,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":120.66,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":117.37,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":119.56,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":109.69,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":120.66,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":115.17,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":106.40,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":109.69,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":115.17,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":111.88,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":109.69,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":109.69,"methodology":"fee schedule"}]}]},{"description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint ","code_information":[{"code":"L2425","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":164.49,"maximum":186.54,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":169.58,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":181.45,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":179.75,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":172.97,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":172.97,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":186.54,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":181.45,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":186.54,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":181.45,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":184.84,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":169.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":186.54,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":178.06,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":164.49,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":169.58,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":178.06,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":172.97,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":169.58,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":169.58,"methodology":"fee schedule"}]}]},{"description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint ","code_information":[{"code":"L2430","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":164.49,"maximum":186.54,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":169.58,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":181.45,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":179.75,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":172.97,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":172.97,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":186.54,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":181.45,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":186.54,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":181.45,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":184.84,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":169.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":186.54,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":178.06,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":164.49,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":169.58,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":178.06,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":172.97,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":169.58,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":169.58,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity fracture orthosis, limited motion knee joint ","code_information":[{"code":"L2184","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":176.26,"maximum":199.88,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":181.71,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":194.43,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":192.61,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":185.34,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":185.34,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":199.88,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":194.43,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":199.88,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":194.43,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":198.06,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":181.71,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":199.88,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":190.80,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":176.26,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":181.71,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":190.80,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":185.34,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":181.71,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":181.71,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity fracture orthosis, waist belt ","code_information":[{"code":"L2190","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":110.68,"maximum":125.51,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":114.10,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":122.09,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":120.95,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":116.38,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":116.38,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":125.51,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":122.09,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":125.51,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":122.09,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":124.37,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":114.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":125.51,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":119.80,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":110.68,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":114.10,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":119.80,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":116.38,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":114.10,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":114.10,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only ","code_information":[{"code":"L2755","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":149.97,"maximum":170.07,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":154.61,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":165.43,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":163.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":157.70,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":157.70,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":170.07,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":165.43,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":170.07,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":165.43,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":168.52,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":154.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":170.07,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":162.34,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":149.97,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":154.61,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":162.34,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":157.70,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":154.61,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":154.61,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity orthosis, knee control, condylar pad ","code_information":[{"code":"L2810","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":83.35,"maximum":94.52,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":85.93,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":91.95,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":91.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":87.65,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":87.65,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":94.52,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":91.95,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":94.52,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":91.95,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":93.66,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":85.93,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":94.52,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":90.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":83.35,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":85.93,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":90.23,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":87.65,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":85.93,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":85.93,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, below knee, total contact ","code_information":[{"code":"L5637","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":328.45,"maximum":372.47,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":338.61,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":362.31,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":358.93,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":345.38,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":345.38,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":372.47,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":362.31,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":372.47,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":362.31,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":369.08,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":338.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":372.47,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":355.54,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":328.45,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":338.61,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":355.54,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":345.38,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":338.61,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":338.61,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system ","code_information":[{"code":"L5610","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":2353.92,"maximum":2669.39,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2426.72,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2596.59,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2572.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2475.25,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2475.25,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2669.39,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2596.59,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2669.39,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2596.59,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2645.12,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2426.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2669.39,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2548.06,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":2353.92,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2426.72,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2548.06,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2475.25,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2426.72,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2426.72,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only ","code_information":[{"code":"L2330","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":419.04,"maximum":475.20,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":432.00,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":462.24,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":457.92,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":440.64,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":440.64,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":475.20,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":462.24,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":475.20,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":462.24,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":470.88,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":432.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":475.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":453.60,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":419.04,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":432.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":453.60,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":440.64,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":432.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":432.00,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, pelvic control, band and belt, bilateral ","code_information":[{"code":"L2640","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":358.63,"maximum":406.69,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":369.72,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":395.60,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":391.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":377.11,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":377.11,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":406.69,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":395.60,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":406.69,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":395.60,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":402.99,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":369.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":406.69,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":388.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":358.63,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":369.72,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":388.21,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":377.11,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":369.72,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":369.72,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint ","code_information":[{"code":"L2387","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":193.98,"maximum":219.98,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":199.98,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":213.98,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":211.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":203.98,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":203.98,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":219.98,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":213.98,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":219.98,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":213.98,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":217.98,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":199.98,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":219.98,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":209.98,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":193.98,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":199.98,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":209.98,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":203.98,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":199.98,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":199.98,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each ","code_information":[{"code":"L5617","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":643.29,"maximum":729.51,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":663.19,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":709.61,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":702.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":676.45,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":676.45,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":729.51,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":709.61,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":729.51,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":709.61,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":722.88,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":663.19,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":729.51,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":696.35,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":643.29,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":663.19,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":696.35,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":676.45,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":663.19,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":663.19,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, symes type, posterior opening (canadian) socket ","code_information":[{"code":"L5634","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":345.84,"maximum":392.19,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":356.54,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":381.50,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":377.93,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":363.67,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":363.67,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":392.19,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":381.50,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":392.19,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":381.50,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":388.63,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":356.54,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":392.19,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":374.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":345.84,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":356.54,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":374.37,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":363.67,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":356.54,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":356.54,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, test socket, hip disarticulation ","code_information":[{"code":"L5626","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":542.07,"maximum":614.72,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":558.84,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":597.96,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":592.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":570.02,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":570.02,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":614.72,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":597.96,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":614.72,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":597.96,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":609.14,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":558.84,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":614.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":586.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":542.07,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":558.84,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":586.78,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":570.02,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":558.84,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":558.84,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model ","code_information":[{"code":"L2525","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1686.67,"maximum":1912.71,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1738.83,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1860.55,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1843.16,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1773.61,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1773.61,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1912.71,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1860.55,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1912.71,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1860.55,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1895.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1738.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1912.71,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1825.77,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1686.67,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1738.83,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1825.77,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1773.61,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1738.83,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1738.83,"methodology":"fee schedule"}]}]},{"description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature ","code_information":[{"code":"L5968","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":4178.10,"maximum":4738.05,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4307.32,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4608.83,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4565.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4393.47,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4393.47,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4738.05,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4608.83,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4738.05,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4608.83,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4694.98,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4307.32,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4738.05,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4522.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4178.10,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4307.32,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4522.69,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4393.47,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4307.32,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4307.32,"methodology":"fee schedule"}]}]},{"description":"Addition to tlso, (low profile), lumbar derotation pad ","code_information":[{"code":"L1240","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":104.40,"maximum":118.39,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":107.63,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":115.16,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":114.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":109.78,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":109.78,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":118.39,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":115.16,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":118.39,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":115.16,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":117.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":107.63,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":118.39,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":113.01,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":104.40,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":107.63,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":113.01,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":109.78,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":107.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":107.63,"methodology":"fee schedule"}]}]},{"description":"Addition to upper extremity orthosis, sock, fracture or equal, each ","code_information":[{"code":"L3995","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":35.72,"maximum":40.50,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":36.82,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":39.40,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":39.03,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":37.56,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":37.56,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":40.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":39.40,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":40.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":39.40,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":40.13,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":36.82,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":40.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":38.66,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":35.72,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":36.82,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":38.66,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":37.56,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":36.82,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":36.82,"methodology":"fee schedule"}]}]},{"description":"Addition to upper extremity prosthesis, below elbow/above elbow, lock mechanism, excludes socket insert ","code_information":[{"code":"L6698","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":653.78,"maximum":741.40,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":674.00,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":721.18,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":714.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":687.48,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":687.48,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":741.40,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":721.18,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":741.40,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":721.18,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":734.66,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":674.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":741.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":707.70,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":653.78,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":674.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":707.70,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":687.48,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":674.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":674.00,"methodology":"fee schedule"}]}]},{"description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment ","code_information":[{"code":"L6890","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":193.38,"maximum":219.30,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":199.36,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":213.32,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":211.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":203.35,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":203.35,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":219.30,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":213.32,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":219.30,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":213.32,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":217.30,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":199.36,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":219.30,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":209.33,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":193.38,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":199.36,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":209.33,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":203.35,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":199.36,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":199.36,"methodology":"fee schedule"}]}]},{"description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame ","code_information":[{"code":"L5826","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":3590.52,"maximum":4071.73,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3701.57,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3960.68,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3923.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3775.60,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3775.60,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4071.73,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3960.68,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4071.73,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3960.68,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4034.71,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3701.57,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4071.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3886.65,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3590.52,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3701.57,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3886.65,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3775.60,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3701.57,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3701.57,"methodology":"fee schedule"}]}]},{"description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control ","code_information":[{"code":"L5830","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":2157.40,"maximum":2446.53,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2224.12,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2379.81,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2357.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2268.60,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2268.60,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2446.53,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2379.81,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2446.53,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2379.81,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2424.29,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2224.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2446.53,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2335.33,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":2157.40,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2224.12,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2335.33,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2268.60,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2224.12,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2224.12,"methodology":"fee schedule"}]}]},{"description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist ","code_information":[{"code":"L5850","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":145.44,"maximum":164.93,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":149.94,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":160.44,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":158.94,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":152.94,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":152.94,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":164.93,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":160.44,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":164.93,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":160.44,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":163.43,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":149.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":164.93,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":157.44,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":145.44,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":149.94,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":157.44,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":152.94,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":149.94,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":149.94,"methodology":"fee schedule"}]}]},{"description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) ","code_information":[{"code":"L5940","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":570.30,"maximum":646.73,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":587.94,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":629.10,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":623.22,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":599.70,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":599.70,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":646.73,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":629.10,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":646.73,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":629.10,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":640.85,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":587.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":646.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":617.34,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":570.30,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":587.94,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":617.34,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":599.70,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":587.94,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":587.94,"methodology":"fee schedule"}]}]},{"description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable ","code_information":[{"code":"L5845","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":2060.81,"maximum":2337.01,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2124.55,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2273.27,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2252.02,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2167.04,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2167.04,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2337.01,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2273.27,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2337.01,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2273.27,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2315.76,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2124.55,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2337.01,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2230.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":2060.81,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2124.55,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2230.78,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2167.04,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2124.55,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2124.55,"methodology":"fee schedule"}]}]},{"description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock ","code_information":[{"code":"L5716","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":828.65,"maximum":939.71,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":854.28,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":914.08,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":905.54,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":871.37,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":871.37,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":939.71,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":914.08,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":939.71,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":914.08,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":931.17,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":854.28,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":939.71,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":896.99,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":828.65,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":854.28,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":896.99,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":871.37,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":854.28,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":854.28,"methodology":"fee schedule"}]}]},{"description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control ","code_information":[{"code":"L5724","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1716.12,"maximum":1946.12,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1769.20,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1893.04,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1875.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1804.58,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1804.58,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1946.12,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1893.04,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1946.12,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1893.04,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1928.43,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1769.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1946.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1857.66,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1716.12,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1769.20,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1857.66,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1804.58,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1769.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1769.20,"methodology":"fee schedule"}]}]},{"description":"Protein c concentrate ","code_information":[{"code":"1139","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":15.05,"maximum":16.56,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15.05,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16.11,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":15.96,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15.35,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15.35,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":16.56,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16.11,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":16.56,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16.11,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16.41,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":15.05,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":16.56,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":15.80,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":15.05,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":15.80,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15.35,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15.05,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15.05,"methodology":"fee schedule"}]}]},{"description":"Prothrombin time; ","code_information":[{"code":"684611","type":"CDM"},{"code":"85610","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3.89,"maximum":5.11,"gross_charge":1157.97,"discounted_cash":1157.97,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4.29,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4.59,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4.38,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4.38,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.72,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4.59,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.72,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4.59,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.68,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4.50,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3.89,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4.29,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5.11,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4.50,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4.38,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4.29,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4.29,"methodology":"fee schedule"}]}]},{"description":"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ","code_information":[{"code":"81321","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":600.00,"maximum":714.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":600.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":642.00,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":636.00,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":612.00,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":612.00,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":660.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":642.00,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":660.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":642.00,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":654.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":600.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":660.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":630.00,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":600.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":714.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":630.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":612.00,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":600.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":600.00,"methodology":"fee schedule"}]}]},{"description":"Pyridoxal phosphate (Vitamin B-6) ","code_information":[{"code":"686467","type":"CDM"},{"code":"84207","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":25.47,"maximum":33.44,"gross_charge":18.80,"discounted_cash":18.80,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":28.10,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":30.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":29.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":28.66,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":28.66,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":30.91,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":30.07,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":30.91,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":30.07,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":30.63,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":28.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":30.91,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":29.51,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":25.47,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":28.10,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":33.44,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":29.51,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":28.66,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":28.10,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":28.10,"methodology":"fee schedule"}]}]},{"description":"Radiation treatment deliv ","code_information":[{"code":"4003","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":142.20,"maximum":156.42,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":142.20,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":152.15,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":150.73,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":145.04,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":145.04,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":156.42,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":152.15,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":156.42,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":152.15,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":155.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":142.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":156.42,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":149.31,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":142.20,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":149.31,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":145.04,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":142.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":142.20,"methodology":"fee schedule"}]}]},{"description":"Radiation treatment deliv ","code_information":[{"code":"4012","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":212.06,"maximum":233.27,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":212.06,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":226.91,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":224.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":216.30,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":216.30,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":233.27,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":226.91,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":233.27,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":226.91,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":231.15,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":212.06,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":233.27,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":222.67,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":212.06,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":222.67,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":216.30,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":212.06,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":212.06,"methodology":"fee schedule"}]}]},{"description":"Receptor assay; non-endocrine (specify receptor) ","code_information":[{"code":"84238","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":33.14,"maximum":43.52,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":36.57,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":39.13,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":38.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":37.30,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":37.30,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":40.23,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":39.13,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":40.23,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":39.13,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":39.86,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":36.57,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":40.23,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":38.40,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":33.14,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":36.57,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":43.52,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":38.40,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":37.30,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":36.57,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":36.57,"methodology":"fee schedule"}]}]},{"description":"Red cell antigen (Kx blood group) genotyping (XK), gene analysis, XK (X-linked Kx blood group) exons 1-3 ","code_information":[{"code":"0200U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":274.83,"maximum":327.05,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":274.83,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":294.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":291.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":280.33,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":280.33,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":302.31,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":294.07,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":302.31,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":294.07,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":299.56,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":274.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":302.31,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":288.57,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":274.83,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":327.05,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":288.57,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":280.33,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":274.83,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":274.83,"methodology":"fee schedule"}]}]},{"description":"Regulator ","code_information":[{"code":"E1353","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":37.48,"maximum":42.50,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":38.64,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":41.34,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":40.96,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":39.41,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":39.41,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":42.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":41.34,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":42.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":41.34,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":42.12,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":38.64,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":42.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":40.57,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":37.48,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":38.64,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":40.57,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":39.41,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":38.64,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":38.64,"methodology":"fee schedule"}]}]},{"description":"RENAL FAILURE WITH CC ","code_information":[{"code":"683","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":45431.83,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":8040.49,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":28103.00,"methodology":"case rate"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8120.89,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":28103.00,"methodology":"case rate"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":8764.13,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8522.92,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":13701.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":19234.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":13701.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8120.89,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8120.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":20542.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":45431.83,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":20542.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":13701.00,"methodology":"case rate"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8844.53,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":14185.07,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":22658.06,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8522.92,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":8764.13,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":8040.49,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8764.13,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7968.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7799.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":8522.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10050.61,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":8040.49,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":8040.49,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":8040.49,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7552.98,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8965.14,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8040.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":7686.70,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8040.49,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":8040.49,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7879.68,"methodology":"fee schedule"}]}]},{"description":"Replace metal bands kafo-afo, calf or distal thigh ","code_information":[{"code":"L4090","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":100.97,"maximum":114.50,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":104.09,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":111.38,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":110.34,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":106.17,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":106.17,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":114.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":111.38,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":114.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":111.38,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":113.46,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":104.09,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":114.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":109.29,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":100.97,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":104.09,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":109.29,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":106.17,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":104.09,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":104.09,"methodology":"fee schedule"}]}]},{"description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each ","code_information":[{"code":"A4234","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":2.29,"maximum":2.60,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2.36,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2.53,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2.50,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2.41,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2.41,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2.60,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2.53,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2.60,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2.53,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2.57,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2.36,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2.48,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":2.29,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2.36,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2.48,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2.41,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2.36,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2.36,"methodology":"fee schedule"}]}]},{"description":"Replacement diaphragm/faceplate for tracheostoma valve, each ","code_information":[{"code":"A7502","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":66.08,"maximum":74.93,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":68.12,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":72.89,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":72.21,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":69.48,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":69.48,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":74.93,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":72.89,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":74.93,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":72.89,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":74.25,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":68.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":74.93,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":71.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":66.08,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":68.12,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":71.53,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":69.48,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":68.12,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":68.12,"methodology":"fee schedule"}]}]},{"description":"Replacement lens shield cartridge for use with laser skin piercing device, each ","code_information":[{"code":"A4257","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":16.89,"maximum":19.15,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17.41,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":18.63,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":18.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17.76,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17.76,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19.15,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":18.63,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":19.15,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":18.63,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":18.98,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":17.41,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":19.15,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":18.28,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.89,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":17.41,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18.28,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":17.76,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17.41,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":17.41,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC ","code_information":[{"code":"177","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":66527.88,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":14258.41,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14400.99,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":15541.67,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":15113.91,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":18750.14,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":26122.14,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":18750.14,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14400.99,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14400.99,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":27601.95,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":66527.88,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":27601.95,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":18750.14,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15684.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":25796.11,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":41204.58,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":15113.91,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":15541.67,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":14258.41,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":15541.67,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14130.08,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":13830.66,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":15113.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":17823.01,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":14258.41,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":14258.41,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":14258.41,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":13735.40,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":15898.13,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14258.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":13631.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14258.41,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":14258.41,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":13973.24,"methodology":"fee schedule"}]}]},{"description":"Safety vest, wheelchair ","code_information":[{"code":"E0980","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":37.19,"maximum":42.17,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":38.34,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":41.02,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":40.64,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":39.11,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":39.11,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":42.17,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":41.02,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":42.17,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":41.02,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":41.79,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":38.34,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":42.17,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":40.26,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":37.19,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":38.34,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":40.26,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":39.11,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":38.34,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":38.34,"methodology":"fee schedule"}]}]},{"description":"Scoliosis, DNA analysis of 53 single nucleotide polymorphisms (SNPs), using saliva, prognostic algorithm reported as a risk score ","code_information":[{"code":"0004M","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":79.00,"maximum":94.01,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":79.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":84.53,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":83.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":80.58,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":80.58,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":86.90,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":84.53,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":86.90,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":84.53,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":86.11,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":79.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":86.90,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":82.95,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":79.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":94.01,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":82.95,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":80.58,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":79.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":79.00,"methodology":"fee schedule"}]}]},{"description":"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ","code_information":[{"code":"G0148","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":28.94,"maximum":38.01,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":31.94,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":34.18,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":33.86,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":32.58,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":32.58,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":35.13,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":34.18,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":35.13,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":34.18,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":34.81,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":31.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":35.13,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":33.54,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":28.94,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":31.94,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":38.01,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":33.54,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":32.58,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":31.94,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":31.94,"methodology":"fee schedule"}]}]},{"description":"Seat lift mechanism, electric, any type ","code_information":[{"code":"E0627","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":297.24,"maximum":337.07,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":306.43,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":327.88,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":324.82,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":312.56,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":312.56,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":337.07,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":327.88,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":337.07,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":327.88,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":334.01,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":306.43,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":337.07,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":321.75,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":297.24,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":306.43,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":321.75,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":312.56,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":306.43,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":306.43,"methodology":"fee schedule"}]}]},{"description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard ","code_information":[{"code":"A6454","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1.04,"maximum":1.18,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1.07,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1.14,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1.13,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1.09,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1.09,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1.18,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1.14,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1.18,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1.14,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1.17,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1.07,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1.18,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1.12,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1.04,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1.07,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1.12,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1.09,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1.07,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1.07,"methodology":"fee schedule"}]}]},{"description":"SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS ","code_information":[{"code":"870","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":74866.19,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":59892.95,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":42950.00,"methodology":"case rate"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":60491.88,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":42950.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_dollar":23884.00,"methodology":"case rate"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":65283.32,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 12. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":63486.53,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 12. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":30648.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":18818.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":28140.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":13701.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":19234.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":13701.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":60491.88,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":60491.88,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":20542.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":55653.13,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":20542.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":13701.00,"methodology":"case rate"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":65882.24,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":39732.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":53569.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":63486.53,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":65283.32,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 12. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":59892.95,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":65283.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":59353.91,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":58096.16,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":63486.53,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":74866.19,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":59892.95,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":59892.95,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":59892.95,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":59109.38,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":66780.64,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":59892.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":57257.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":59892.95,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":59892.95,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":58695.09,"methodology":"fee schedule"}]}]},{"description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm ","code_information":[{"code":"L6300","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":4235.84,"maximum":4803.54,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4366.85,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4672.53,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4628.86,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4454.19,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4454.19,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4803.54,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4672.53,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4803.54,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4672.53,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4759.87,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4366.85,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4803.54,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4585.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4235.84,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4366.85,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4585.19,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4454.19,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4366.85,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4366.85,"methodology":"fee schedule"}]}]},{"description":"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC ","code_information":[{"code":"511","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":55248.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":17205.85,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17377.91,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":18754.38,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":18238.20,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":55248.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":26654.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":50733.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":6682.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":9309.66,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":6682.35,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17377.91,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17377.91,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":9837.05,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":23709.84,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":9837.05,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":6682.35,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":18926.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":31300.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":49996.09,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":18238.20,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":18754.38,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":17205.85,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":18754.38,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":19356.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":16689.67,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":18238.20,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":21507.31,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":17205.85,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":17205.85,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":17205.85,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16666.02,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19184.52,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":17205.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":29569.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":16448.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":22098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17205.85,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":17205.85,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":16861.73,"methodology":"fee schedule"}]}]},{"description":"Sipuleucel-T auto CD54+ ","code_information":[{"code":"9273","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":55015.23,"maximum":60516.75,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":55015.23,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":58866.30,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":58316.14,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":56115.53,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":56115.53,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":60516.75,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":58866.30,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":60516.75,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":58866.30,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":59966.60,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":55015.23,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":60516.75,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":57765.99,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":55015.23,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":57765.99,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":56115.53,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":55015.23,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":55015.23,"methodology":"fee schedule"}]}]},{"description":"SKIN DEBRIDEMENT WITH CC ","code_information":[{"code":"571","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":83135.78,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":14756.63,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14904.20,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16084.73,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":15642.03,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":23430.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":32643.22,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":23430.89,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14904.20,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14904.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":34492.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":83135.78,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":34492.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":23430.89,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":16232.29,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":26726.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":42690.65,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":15642.03,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16084.73,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":14756.63,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16084.73,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14623.82,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14313.93,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":15642.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18445.79,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":14756.63,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":14756.63,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":14756.63,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":14230.78,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":16453.64,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14756.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":14107.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14756.63,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":14756.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14461.50,"methodology":"fee schedule"}]}]},{"description":"SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC ","code_information":[{"code":"575","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":74967.68,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":17505.81,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17680.87,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19081.33,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":18556.16,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":21128.80,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":29436.02,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":21128.80,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17680.87,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17680.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":31103.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":74967.68,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":31103.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":21128.80,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19256.39,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":31860.15,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":50890.78,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":18556.16,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19081.33,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":17505.81,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":19081.33,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":17348.26,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":16980.64,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":18556.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":21882.26,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":17505.81,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":17505.81,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":17505.81,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16964.26,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19518.98,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":17505.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":16735.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17505.81,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":17505.81,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":17155.69,"methodology":"fee schedule"}]}]},{"description":"SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC ","code_information":[{"code":"905","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":56764.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":14528.45,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14673.73,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":15836.01,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":15400.16,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":15998.30,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":22288.35,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":15998.30,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14673.73,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14673.73,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":23550.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":56764.00,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":23550.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":15998.30,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15981.30,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":26300.38,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":42010.07,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":15400.16,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":15836.01,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":14528.45,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":15836.01,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14397.69,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14092.60,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":15400.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18160.56,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":14528.45,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":14528.45,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":14528.45,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":14003.91,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":16199.22,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14528.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":13889.20,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14528.45,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":14528.45,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14237.88,"methodology":"fee schedule"}]}]},{"description":"SKIN ULCERS WITHOUT CC/MCC ","code_information":[{"code":"594","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":43375.19,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":7696.09,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7773.05,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":8388.74,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8157.86,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":12224.81,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":17031.24,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":12224.81,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":7773.05,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":7773.05,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":17996.06,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":43375.19,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":17996.06,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":12224.81,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8465.70,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":13541.96,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":21630.81,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8157.86,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":8388.74,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":7696.09,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8388.74,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7626.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7465.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":8157.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":9620.11,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":7696.09,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":7696.09,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":7696.09,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7210.55,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8581.14,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":7696.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":7357.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":7696.09,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":7696.09,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7542.17,"methodology":"fee schedule"}]}]},{"description":"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ","code_information":[{"code":"87207","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":5.43,"maximum":7.13,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5.99,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6.41,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6.11,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6.11,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6.59,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6.41,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":6.59,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6.41,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6.53,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5.99,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6.59,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6.29,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":5.43,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5.99,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7.13,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6.29,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6.11,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5.99,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5.99,"methodology":"fee schedule"}]}]},{"description":"Sodium; urine ","code_information":[{"code":"684701","type":"CDM"},{"code":"84300","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":4.59,"maximum":6.02,"gross_charge":657.03,"discounted_cash":657.03,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5.06,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":5.41,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":5.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5.16,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5.16,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":5.57,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":5.41,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":5.57,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":5.41,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":5.52,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5.06,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5.57,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5.31,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4.59,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5.06,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":6.02,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":5.31,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5.16,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5.06,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5.06,"methodology":"fee schedule"}]}]},{"description":"Somatostatin ","code_information":[{"code":"84307","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":16.57,"maximum":21.75,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":18.28,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19.56,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":19.38,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":18.65,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":18.65,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":20.11,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19.56,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":20.11,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.56,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":19.93,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":18.28,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":20.11,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.57,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.28,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":21.75,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19.19,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":18.65,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18.28,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18.28,"methodology":"fee schedule"}]}]},{"description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing ","code_information":[{"code":"A6252","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":4.31,"maximum":4.88,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4.44,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4.75,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4.53,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4.53,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.88,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4.75,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.88,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4.75,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.84,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4.44,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.88,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4.66,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4.31,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4.44,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4.66,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4.53,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4.44,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4.44,"methodology":"fee schedule"}]}]},{"description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device ","code_information":[{"code":"E2508","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":4733.69,"maximum":5368.10,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4880.09,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":5221.70,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":5172.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4977.69,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4977.69,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":5368.10,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":5221.70,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":5368.10,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":5221.70,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":5319.30,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4880.09,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5368.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5124.09,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4733.69,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4880.09,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":5124.09,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4977.69,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4880.09,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4880.09,"methodology":"fee schedule"}]}]},{"description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens ","code_information":[{"code":"V2203","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":58.81,"maximum":66.69,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":60.63,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":64.87,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":64.27,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":61.84,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":61.84,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":66.69,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":64.87,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":66.69,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":64.87,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":66.09,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":60.63,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":66.69,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":63.66,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":58.81,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":60.63,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":63.66,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":61.84,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":60.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":60.63,"methodology":"fee schedule"}]}]},{"description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens ","code_information":[{"code":"V2214","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":103.87,"maximum":117.79,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":107.08,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":114.58,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":113.50,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":109.22,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":109.22,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":117.79,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":114.58,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":117.79,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":114.58,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":116.72,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":107.08,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":117.79,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":112.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":103.87,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":107.08,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":112.43,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":109.22,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":107.08,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":107.08,"methodology":"fee schedule"}]}]},{"description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens ","code_information":[{"code":"V2304","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":83.38,"maximum":94.56,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":85.96,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":91.98,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":91.12,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":87.68,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":87.68,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":94.56,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":91.98,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":94.56,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":91.98,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":93.70,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":85.96,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":94.56,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":90.26,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":83.38,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":85.96,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":90.26,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":87.68,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":85.96,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":85.96,"methodology":"fee schedule"}]}]},{"description":"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC ","code_information":[{"code":"537","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":23422.76,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":8296.86,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8379.83,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":9043.58,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8794.67,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":5863.30,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":8168.57,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":5863.30,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8379.83,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8379.83,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":8631.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":20803.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":8631.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":5863.30,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":9126.55,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":14663.81,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":23422.76,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8794.67,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":9043.58,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":8296.86,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":9043.58,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8222.19,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8047.95,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":8794.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10371.08,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":8296.86,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":8296.86,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":8296.86,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7807.89,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9251.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8296.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":7931.80,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8296.86,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":8296.86,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8130.92,"methodology":"fee schedule"}]}]},{"description":"Static progressive stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories ","code_information":[{"code":"E1816","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":165.06,"maximum":187.18,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":170.16,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":182.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":180.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":173.56,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":173.56,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":187.18,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":182.07,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":187.18,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":182.07,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":185.47,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":170.16,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":187.18,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":178.67,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":165.06,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":170.16,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":178.67,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":173.56,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":170.16,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":170.16,"methodology":"fee schedule"}]}]},{"description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist ","code_information":[{"code":"A4542","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":489.28,"maximum":554.85,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":504.41,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":539.72,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":534.67,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":514.50,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":514.50,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":554.85,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":539.72,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":554.85,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":539.72,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":549.81,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":504.41,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":554.85,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":529.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":489.28,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":504.41,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":529.63,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":514.50,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":504.41,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":504.41,"methodology":"fee schedule"}]}]},{"description":"Syphilis test, non-treponemal antibody, immunoassay, qualitative (RPR) ","code_information":[{"code":"0065U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":16.39,"maximum":21.53,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":18.09,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19.36,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":19.18,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":18.45,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":18.45,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19.90,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19.36,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":19.90,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.36,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":19.72,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":18.09,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":19.90,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":18.99,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.39,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.09,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":21.53,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18.99,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":18.45,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18.09,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18.09,"methodology":"fee schedule"}]}]},{"description":"Tape, waterproof, per 18 square inches ","code_information":[{"code":"A4452","type":"HCPCS"}],"standard_charges":[{"modifiers":"AU","modifiers_description":"Item furnished in conjunction with a urological, ostomy, or tracheostomy supply","setting":"outpatient","minimum":0.47,"maximum":0.53,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":0.48,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":0.51,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":0.51,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":0.49,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":0.49,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":0.53,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":0.51,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":0.53,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":0.51,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":0.52,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":0.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":0.53,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":0.50,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":0.47,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":0.48,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":0.50,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":0.49,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":0.48,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":0.48,"methodology":"fee schedule"}]}]},{"description":"Targeted genomic sequence analysis, solid organ neoplasm, DNA analysis of 324 genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements, microsatellite instabiit ","code_information":[{"code":"0037U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3172.29,"maximum":4165.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3500.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3745.00,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3710.00,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3570.00,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3570.00,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3850.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3745.00,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3850.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3745.00,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3815.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3500.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3850.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3675.00,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3172.29,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3500.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":4165.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3675.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3570.00,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3500.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3500.00,"methodology":"fee schedule"}]}]},{"description":"Tc-99m graphite crucible ","code_information":[{"code":"760","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":328.60,"maximum":361.46,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":328.60,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":351.60,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":348.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":335.17,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":335.17,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":361.46,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":351.60,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":361.46,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":351.60,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":358.17,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":328.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":361.46,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":345.03,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":328.60,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":345.03,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":335.17,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":328.60,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":328.60,"methodology":"fee schedule"}]}]},{"description":"Terminal device, hand, mechanical, voluntary closing, any material, any size ","code_information":[{"code":"L6709","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1377.45,"maximum":1562.06,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1420.05,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1519.45,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1505.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1448.45,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1448.45,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1562.06,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1519.45,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1562.06,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1519.45,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1547.85,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1420.05,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1562.06,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1491.05,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1377.45,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1420.05,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1491.05,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1448.45,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1420.05,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1420.05,"methodology":"fee schedule"}]}]},{"description":"TESTES PROCEDURES WITHOUT CC/MCC ","code_information":[{"code":"712","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":27264.10,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":9584.71,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":9680.56,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":10447.33,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10159.79,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":5588.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":7786.41,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":5588.98,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":9680.56,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":9680.56,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":8227.51,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":19830.43,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":8227.51,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":5588.98,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":10543.18,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":17068.68,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":27264.10,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10159.79,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10447.33,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":9584.71,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":10447.33,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":9498.45,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9297.17,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":10159.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":11980.89,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":9584.71,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":9584.71,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":9584.71,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":9088.39,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":10686.95,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":9584.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":9162.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":9584.71,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":9584.71,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":9393.02,"methodology":"fee schedule"}]}]},{"description":"Theophylline ","code_information":[{"code":"684737","type":"CDM"},{"code":"80198","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":12.81,"maximum":16.83,"gross_charge":857.89,"discounted_cash":857.89,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14.14,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":15.13,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":14.99,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14.42,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14.42,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15.55,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":15.13,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":15.55,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":15.13,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":15.41,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":14.14,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15.55,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14.85,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":12.81,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":14.14,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16.83,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":14.85,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14.42,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14.14,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14.14,"methodology":"fee schedule"}]}]},{"description":"Thymol turbidity, blood ","code_information":[{"code":"P2033","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":4.69,"maximum":5.89,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4.95,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":5.30,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":5.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5.05,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5.05,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":5.45,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":5.30,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":5.45,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":5.30,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":5.40,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4.95,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5.45,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5.20,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4.69,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4.95,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5.89,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":5.20,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5.05,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4.95,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4.95,"methodology":"fee schedule"}]}]},{"description":"Thyroxine; requiring elution (eg, neonatal) ","code_information":[{"code":"84437","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":5.87,"maximum":7.70,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":6.47,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6.92,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6.86,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6.60,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6.60,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7.12,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6.92,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":7.12,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6.92,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7.05,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":6.47,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":5.87,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":6.47,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7.70,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6.79,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6.60,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6.47,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6.47,"methodology":"fee schedule"}]}]},{"description":"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ","code_information":[{"code":"87220","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3.87,"maximum":5.08,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4.27,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4.57,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4.53,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4.36,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4.36,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.70,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4.57,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.70,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4.57,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.65,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4.27,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.70,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4.48,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3.87,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4.27,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5.08,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4.48,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4.36,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4.27,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4.27,"methodology":"fee schedule"}]}]},{"description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided ","code_information":[{"code":"L0469","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":352.97,"maximum":400.28,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":363.89,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":389.36,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":385.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":371.17,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":371.17,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":400.28,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":389.36,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":400.28,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":389.36,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":396.64,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":363.89,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":400.28,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":382.08,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":352.97,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":363.89,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":382.08,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":371.17,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":363.89,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":363.89,"methodology":"fee schedule"}]}]},{"description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior exte ","code_information":[{"code":"L0458","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1023.40,"maximum":1160.56,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1055.05,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1128.90,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1118.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1076.15,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1076.15,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1160.56,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1128.90,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1160.56,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1128.90,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1150.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1055.05,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1160.56,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1107.80,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1023.40,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1055.05,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1107.80,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1076.15,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1055.05,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1055.05,"methodology":"fee schedule"}]}]},{"description":"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC ","code_information":[{"code":"013","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":112324.27,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":23088.78,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":23319.67,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":25166.77,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":24474.11,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":31657.34,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":44104.06,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":31657.34,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":23319.67,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":23319.67,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":46602.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":112324.27,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":46602.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":31657.34,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":25397.66,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":42285.51,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":67543.40,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":24474.11,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":25166.77,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":23088.78,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":25166.77,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":22880.98,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":22396.12,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":24474.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":28860.97,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":23088.78,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":23088.78,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":23088.78,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":22515.35,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":25743.99,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":23088.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":22072.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":23088.78,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":23088.78,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":22627.00,"methodology":"fee schedule"}]}]},{"description":"Traction equipment, overdoor, cervical ","code_information":[{"code":"E0860","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":49.43,"maximum":56.06,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":50.96,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":54.53,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":54.02,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":51.98,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":51.98,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":56.06,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":54.53,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":56.06,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":54.53,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":55.55,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":50.96,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":56.06,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":53.51,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":49.43,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":50.96,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":53.51,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":51.98,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":50.96,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":50.96,"methodology":"fee schedule"}]}]},{"description":"Transferrin ","code_information":[{"code":"686399","type":"CDM"},{"code":"84466","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":11.56,"maximum":15.18,"gross_charge":83.37,"discounted_cash":83.37,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12.76,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13.65,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13.53,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":13.02,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":13.02,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":14.04,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13.65,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":14.04,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13.65,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13.91,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":12.76,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14.04,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":13.40,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":11.56,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12.76,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":15.18,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":13.40,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":13.02,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12.76,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12.76,"methodology":"fee schedule"}]}]},{"description":"TRANSURETHRAL PROSTATECTOMY WITH CC/MCC ","code_information":[{"code":"713","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":36855.99,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":12800.49,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12928.49,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13952.53,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13568.52,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":9566.02,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":13327.10,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":9566.02,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":12928.49,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":12928.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":14082.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":33941.46,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":14082.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":9566.02,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":14080.54,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":23073.67,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":36855.99,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13568.52,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13952.53,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":12800.49,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13952.53,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":12685.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":12416.48,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":13568.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":16000.61,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":12800.49,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":12800.49,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":12800.49,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":12285.81,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":14272.55,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":12800.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":12237.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12800.49,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":12800.49,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12544.48,"methodology":"fee schedule"}]}]},{"description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar ","code_information":[{"code":"E0911","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":48.62,"maximum":55.13,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":50.12,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":53.63,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":53.13,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":51.12,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":51.12,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":55.13,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":53.63,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":55.13,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":53.63,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":54.63,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":50.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":55.13,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":52.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":48.62,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":50.12,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":52.63,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":51.12,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":50.12,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":50.12,"methodology":"fee schedule"}]}]},{"description":"Triiodothyronine T3; reverse ","code_information":[{"code":"686331","type":"CDM"},{"code":"84482","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":14.29,"maximum":18.75,"gross_charge":5.70,"discounted_cash":5.70,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15.76,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16.86,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":16.08,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":16.08,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":17.34,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16.86,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":17.34,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16.86,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":17.18,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":15.76,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":17.34,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":16.55,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":14.29,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":15.76,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":18.75,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":16.55,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":16.08,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15.76,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15.76,"methodology":"fee schedule"}]}]},{"description":"Trypsin; feces, qualitative ","code_information":[{"code":"686419","type":"CDM"},{"code":"84488","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":6.62,"maximum":8.69,"gross_charge":547.26,"discounted_cash":547.26,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7.30,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":7.81,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":7.45,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":7.45,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8.03,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":7.81,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":8.03,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7.81,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7.96,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":7.30,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8.03,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7.67,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":6.62,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7.30,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":8.69,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":7.67,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":7.45,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":7.30,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7.30,"methodology":"fee schedule"}]}]},{"description":"U-v lens, per lens ","code_information":[{"code":"V2755","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":20.91,"maximum":23.72,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":21.56,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":23.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":22.85,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":21.99,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":21.99,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":23.72,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":23.07,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":23.72,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":23.07,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":23.50,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":21.56,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":23.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":22.64,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":20.91,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":21.56,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":22.64,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":21.99,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":21.56,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":21.56,"methodology":"fee schedule"}]}]},{"description":"Ultrasound Composite ","code_information":[{"code":"8004","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":295.40,"maximum":324.94,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":295.40,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":316.08,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":313.13,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":301.31,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":301.31,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":324.94,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":316.08,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":324.94,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":316.08,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":321.99,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":295.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":324.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":310.17,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":295.40,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":310.17,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":301.31,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":295.40,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":295.40,"methodology":"fee schedule"}]}]},{"description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (FF ","code_information":[{"code":"0266U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3200.00,"maximum":3808.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3200.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3424.00,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3392.00,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3264.00,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3264.00,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3520.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3424.00,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3520.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3424.00,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3488.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3200.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3520.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3360.00,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3200.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":3808.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3360.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3264.00,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3200.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3200.00,"methodology":"fee schedule"}]}]},{"description":"Upper extremity addition, frame type socket, shoulder disarticulation ","code_information":[{"code":"L6689","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":781.00,"maximum":885.67,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":805.15,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":861.51,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":853.46,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":821.25,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":821.25,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":885.67,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":861.51,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":885.67,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":861.51,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":877.61,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":805.15,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":885.67,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":845.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":781.00,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":805.15,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":845.41,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":821.25,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":805.15,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":805.15,"methodology":"fee schedule"}]}]},{"description":"Upper extremity addition, removable insert, each ","code_information":[{"code":"L6691","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":393.90,"maximum":446.69,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":434.51,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":430.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":414.20,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":414.20,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":446.69,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":434.51,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":446.69,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":434.51,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":442.63,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":446.69,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":426.38,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":393.90,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":426.38,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":414.20,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":406.08,"methodology":"fee schedule"}]}]},{"description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system ","code_information":[{"code":"L6646","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":3626.31,"maximum":4112.31,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3738.46,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4000.15,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3962.77,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3813.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3813.23,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4112.31,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4000.15,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4112.31,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4000.15,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4074.92,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3738.46,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4112.31,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3925.38,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3626.31,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3738.46,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3925.38,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3813.23,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3738.46,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3738.46,"methodology":"fee schedule"}]}]},{"description":"Upper extremity additions, flexible metal hinge, pair ","code_information":[{"code":"L6610","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":202.22,"maximum":229.32,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":208.47,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":223.06,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":220.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":212.64,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":212.64,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":229.32,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":223.06,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":229.32,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":223.06,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":227.23,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":208.47,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":229.32,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":218.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":202.22,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":208.47,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":218.89,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":212.64,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":208.47,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":208.47,"methodology":"fee schedule"}]}]},{"description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment ","code_information":[{"code":"L3980","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":322.84,"maximum":366.10,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":332.82,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":356.12,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":352.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":339.48,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":339.48,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":366.10,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":356.12,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":366.10,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":356.12,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":362.77,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":332.82,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":366.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":349.46,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":322.84,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":332.82,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":349.46,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":339.48,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":332.82,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":332.82,"methodology":"fee schedule"}]}]},{"description":"UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC ","code_information":[{"code":"257","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":65062.79,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":8066.12,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8146.79,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":8792.08,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8550.09,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":18337.22,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":25546.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":18337.22,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8146.79,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8146.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":26994.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":65062.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":26994.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":18337.22,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8872.74,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":14232.94,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":22734.53,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8550.09,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":8792.08,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":8066.12,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8792.08,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7993.53,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7824.14,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":8550.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10082.65,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":8066.12,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":8066.12,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":8066.12,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7578.47,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8993.73,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8066.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":7711.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8066.12,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":8066.12,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7904.80,"methodology":"fee schedule"}]}]},{"description":"Uric acid; blood ","code_information":[{"code":"684776","type":"CDM"},{"code":"84550","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":4.09,"maximum":5.38,"gross_charge":1182.17,"discounted_cash":1182.17,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4.52,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4.84,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4.61,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4.61,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.97,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4.84,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.97,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4.84,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.93,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4.52,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.97,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4.75,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4.09,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4.52,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5.38,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4.75,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4.61,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4.52,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4.52,"methodology":"fee schedule"}]}]},{"description":"Urinalysis; qualitative or semiquantitative, except immunoassays ","code_information":[{"code":"81005","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":1.97,"maximum":2.58,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2.17,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2.32,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2.30,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2.21,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2.21,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2.39,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2.32,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2.39,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2.32,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2.37,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2.17,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2.39,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2.28,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1.97,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2.17,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":2.58,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2.28,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2.21,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2.17,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2.17,"methodology":"fee schedule"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC ","code_information":[{"code":"738","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":72577.44,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":13406.39,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":13540.45,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":14612.97,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":14210.77,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":20455.14,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":28497.49,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":20455.14,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":13540.45,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":13540.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":30111.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":72577.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":30111.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":20455.14,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":14747.03,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":24205.09,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":38663.23,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":14210.77,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":14612.97,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":13406.39,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":14612.97,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":13285.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":13004.20,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":14210.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":16757.99,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":13406.39,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":13406.39,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":13406.39,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":12888.25,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":14948.12,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":13406.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":12816.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":13406.39,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":13406.39,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":13138.26,"methodology":"fee schedule"}]}]},{"description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens ","code_information":[{"code":"V2430","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":132.72,"maximum":150.50,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":136.82,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":146.40,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":145.03,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":139.56,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":139.56,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":150.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":146.40,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":150.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":146.40,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":149.13,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":136.82,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":150.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":143.66,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":132.72,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":136.82,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":143.66,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":139.56,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":136.82,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":136.82,"methodology":"fee schedule"}]}]},{"description":"Vasoactive intestinal peptide (VIP) ","code_information":[{"code":"686448","type":"CDM"},{"code":"84586","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":32.02,"maximum":42.04,"gross_charge":45.71,"discounted_cash":45.71,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":35.33,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":37.80,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":37.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":36.04,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":36.04,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":38.86,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":37.80,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":38.86,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":37.80,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":38.51,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":35.33,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":38.86,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":37.10,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":32.02,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":35.33,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":42.04,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":37.10,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":36.04,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":35.33,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":35.33,"methodology":"fee schedule"}]}]},{"description":"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ","code_information":[{"code":"87253","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":18.30,"maximum":24.04,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":20.20,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":21.61,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":21.41,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":20.60,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":20.60,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":22.22,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":21.61,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":22.22,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":21.61,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":22.02,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":20.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":22.22,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":21.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":18.30,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":20.20,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":24.04,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":21.21,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":20.60,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":20.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":20.20,"methodology":"fee schedule"}]}]},{"description":"Vitamin K ","code_information":[{"code":"84597","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":12.44,"maximum":16.33,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":13.72,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":14.68,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":14.54,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":13.99,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":13.99,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15.09,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":14.68,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":15.09,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":14.68,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":14.95,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":13.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15.09,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":12.44,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":13.72,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16.33,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":14.41,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":13.99,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":13.72,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":13.72,"methodology":"fee schedule"}]}]},{"description":"Voriconazole ","code_information":[{"code":"718805","type":"CDM"},{"code":"80285","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":24.57,"maximum":32.26,"gross_charge":83.40,"discounted_cash":83.40,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":27.11,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":29.01,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":28.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":27.65,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":27.65,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":29.82,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":29.01,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":29.82,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":29.01,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":29.55,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":27.11,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":29.82,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":28.47,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":24.57,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":27.11,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":32.26,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":28.47,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":27.65,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":27.11,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":27.11,"methodology":"fee schedule"}]}]},{"description":"Water pressure pad for mattress, standard mattress length and width ","code_information":[{"code":"E0198","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":29.33,"maximum":33.26,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":30.24,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":32.36,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":32.05,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":30.84,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":30.84,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":33.26,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":32.36,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":33.26,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":32.36,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":32.96,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":30.24,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":33.26,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":31.75,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":29.33,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":30.24,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":31.75,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":30.84,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":30.24,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":30.24,"methodology":"fee schedule"}]}]},{"description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot ","code_information":[{"code":"E0954","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":61.06,"maximum":69.25,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":62.95,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":67.36,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":66.73,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":64.21,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":64.21,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":69.25,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":67.36,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":69.25,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":67.36,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":68.62,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":62.95,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":69.25,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":66.10,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":61.06,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":62.95,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":66.10,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":64.21,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":62.95,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":62.95,"methodology":"fee schedule"}]}]},{"description":"Wheelchair accessory, power seatng system, recline only, with power shear reduction ","code_information":[{"code":"E1005","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":598.08,"maximum":678.24,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":616.58,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":659.74,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":653.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":628.91,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":628.91,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":678.24,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":659.74,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":678.24,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":659.74,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":672.07,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":616.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":678.24,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":647.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":598.08,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":616.58,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":647.41,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":628.91,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":616.58,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":616.58,"methodology":"fee schedule"}]}]},{"description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system ","code_information":[{"code":"E1233","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":293.24,"maximum":332.54,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":302.31,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":323.47,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":320.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":308.36,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":308.36,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":332.54,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":323.47,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":332.54,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":323.47,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":329.52,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":302.31,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":332.54,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":317.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":293.24,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":302.31,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":317.43,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":308.36,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":302.31,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":302.31,"methodology":"fee schedule"}]}]},{"description":"WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC ","code_information":[{"code":"903","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":70231.90,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":10861.45,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":10970.06,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":11838.98,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":11513.14,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":19794.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":27576.52,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":19794.08,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":10970.06,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":10970.06,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":29138.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":70231.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":29138.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":19794.08,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":11947.60,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":19452.80,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":31072.31,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":11513.14,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":11838.98,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":10861.45,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":11838.98,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":10763.70,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":10535.61,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":11513.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":13576.81,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":10861.45,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":10861.45,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":10861.45,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":10357.84,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":12110.52,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":10861.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":10383.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":10861.45,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":10861.45,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":10644.22,"methodology":"fee schedule"}]}]},{"description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device ","code_information":[{"code":"L6920","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":7587.68,"maximum":8604.59,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7822.35,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":8369.91,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8291.69,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":7978.80,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":7978.80,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8604.59,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8369.91,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":8604.59,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":8369.91,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8526.36,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":7822.35,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8604.59,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8213.47,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":7587.68,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7822.35,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8213.47,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":7978.80,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":7822.35,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7822.35,"methodology":"fee schedule"}]}]},{"description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each ","code_information":[{"code":"L8621","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":0.71,"maximum":0.80,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":0.73,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":0.78,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":0.77,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":0.74,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":0.74,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":0.80,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":0.78,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":0.80,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":0.78,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":0.80,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":0.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":0.80,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":0.77,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":0.71,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":0.73,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":0.77,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":0.74,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":0.73,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":0.73,"methodology":"fee schedule"}]}]},{"description":" Emergency Room Other  ","code_information":[{"code":"459","type":"RC"}],"standard_charges":[{"setting":"outpatient","minimum":735.00,"maximum":5635.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":821.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":3449.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":3449.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_dollar":1918.00,"methodology":"case rate"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":895.00,"methodology":"case rate"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":895.00,"methodology":"case rate"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":825.00,"methodology":"case rate"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":895.00,"methodology":"case rate"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":895.00,"methodology":"case rate"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":977.00,"methodology":"case rate"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":900.00,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":5635.00,"methodology":"case rate"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":960.00,"methodology":"case rate"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":985.00,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":5635.00,"methodology":"case rate"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":800.00,"methodology":"case rate"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":800.00,"methodology":"case rate"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":977.00,"methodology":"case rate"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":977.00,"methodology":"case rate"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":977.00,"methodology":"case rate"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":795.00,"methodology":"case rate"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":735.00,"methodology":"case rate"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":1400.00,"methodology":"case rate"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":985.00,"methodology":"case rate"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":750.00,"methodology":"case rate"}]}]},{"description":"AbobotulinumtoxinA ","code_information":[{"code":"1289","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":8.63,"maximum":9.49,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8.63,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":9.23,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":9.15,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8.80,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8.80,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":9.49,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":9.23,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":9.49,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":9.23,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":9.41,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":8.63,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":9.49,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9.06,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8.63,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9.06,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8.80,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8.63,"methodology":"fee schedule"}]}]},{"description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot ","code_information":[{"code":"L5230","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":4325.14,"maximum":4904.80,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4458.91,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4771.03,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4726.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4548.09,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4548.09,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4904.80,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4771.03,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4904.80,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4771.03,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4860.21,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4458.91,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4904.80,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4681.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4325.14,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4458.91,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4681.86,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4548.09,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4458.91,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4458.91,"methodology":"fee schedule"}]}]},{"description":"Acetaminophen ","code_information":[{"code":"712247","type":"CDM"},{"code":"80143","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":16.90,"maximum":22.18,"gross_charge":2785.42,"discounted_cash":2785.42,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":19.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":20.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19.57,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.90,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":22.18,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19.57,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18.64,"methodology":"fee schedule"}]}]},{"description":"ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION ","code_information":[{"code":"880","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":20944.73,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8722.49,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":9413.38,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":9154.30,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":5903.04,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":8223.94,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":5903.04,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8722.49,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8722.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":8689.82,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":20944.73,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":8689.82,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":5903.04,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":9499.74,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":9154.30,"methodology":"fee schedule"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":9413.38,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":9413.38,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8558.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8377.04,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":9154.30,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10795.16,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":8145.22,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9629.28,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8636.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":8256.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8636.13,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":8636.13,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8463.41,"methodology":"fee schedule"}]}]},{"description":"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA ","code_information":[{"code":"684040","type":"CDM"},{"code":"80074","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":43.17,"maximum":56.68,"gross_charge":2438.15,"discounted_cash":2438.15,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":47.63,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":50.96,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":50.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":48.58,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":48.58,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":52.39,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":50.96,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":52.39,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":50.96,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":51.92,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":47.63,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":52.39,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":50.01,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":43.17,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":47.63,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":56.68,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":50.01,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":48.58,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":47.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":47.63,"methodology":"fee schedule"}]}]},{"description":"ACUTE LEUKEMIA WITH MCC ","code_information":[{"code":"834","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":140880.68,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":47675.88,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":48152.64,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":51966.71,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":50536.43,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":22560.46,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":31430.56,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":22560.46,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":48152.64,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":48152.64,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":33211.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":80047.38,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":33211.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":22560.46,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":52443.47,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":88198.27,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":140880.68,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":50536.43,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":51966.71,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":47675.88,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":51966.71,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":47246.80,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":46245.60,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":50536.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":59594.85,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":47675.88,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":47675.88,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":47675.88,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":46962.07,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":53158.61,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":47675.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":45578.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":47675.88,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":47675.88,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":46722.36,"methodology":"fee schedule"}]}]},{"description":"Addition to ctlso or scoliosis orthosis, kyphosis pad ","code_information":[{"code":"L1020","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":119.21,"maximum":135.19,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":122.90,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":131.50,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":130.27,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":125.36,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":125.36,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":135.19,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":131.50,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":135.19,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":131.50,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":133.96,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":122.90,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":135.19,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":129.05,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":119.21,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":122.90,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":129.05,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":125.36,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":122.90,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":122.90,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type ","code_information":[{"code":"L2186","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":195.32,"maximum":221.50,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":201.36,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":215.46,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":213.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":205.39,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":205.39,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":221.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":215.46,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":221.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":215.46,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":219.48,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":201.36,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":221.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":211.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":195.32,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":201.36,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":211.43,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":205.39,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":201.36,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":201.36,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s) ","code_information":[{"code":"L5859","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":16682.06,"maximum":18917.80,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17198.00,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":18401.86,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":18229.88,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17541.96,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17541.96,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":18917.80,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":18401.86,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":18917.80,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":18401.86,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":18745.82,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":17198.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":18917.80,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":18057.90,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16682.06,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":17198.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18057.90,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":17541.96,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17198.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":17198.00,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, below knee, back check (extension control) ","code_information":[{"code":"L5686","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":58.08,"maximum":65.87,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":59.88,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":64.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":63.47,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":61.08,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":61.08,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":65.87,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":64.07,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":65.87,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":64.07,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":65.27,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":59.88,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":65.87,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":62.87,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":58.08,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":59.88,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":62.87,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":61.08,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":59.88,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":59.88,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, below knee, waist belt, webbing ","code_information":[{"code":"L5688","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":69.45,"maximum":78.76,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":71.60,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":76.61,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":75.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":73.03,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":73.03,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":78.76,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":76.61,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":78.76,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":76.61,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":78.04,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":71.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":78.76,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":75.18,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":69.45,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":71.60,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":75.18,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":73.03,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":71.60,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":71.60,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control ","code_information":[{"code":"L5611","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1831.83,"maximum":2077.33,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1888.48,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2020.67,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2001.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1926.25,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1926.25,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2077.33,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2020.67,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2077.33,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2020.67,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2058.44,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1888.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2077.33,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1982.90,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1831.83,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1888.48,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1982.90,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1926.25,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1888.48,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1888.48,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment ","code_information":[{"code":"L2250","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":379.20,"maximum":430.02,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":390.93,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":418.30,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":414.39,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":398.75,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":398.75,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":430.02,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":418.30,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":430.02,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":418.30,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":426.11,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":390.93,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":430.02,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":410.48,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":379.20,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":390.93,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":410.48,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":398.75,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":390.93,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":390.93,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, offset knee joint, each joint ","code_information":[{"code":"L2390","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":116.82,"maximum":132.47,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":120.43,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":128.86,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":127.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":132.47,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":128.86,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":132.47,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":128.86,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":131.27,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":120.43,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":132.47,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":126.45,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":116.82,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":120.43,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":126.45,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":120.43,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":120.43,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables ","code_information":[{"code":"L2627","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1832.98,"maximum":2078.64,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1889.67,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2021.95,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2003.05,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1927.46,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1927.46,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2078.64,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2021.95,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2078.64,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2021.95,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2059.74,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1889.67,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2078.64,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1984.15,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1832.98,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1889.67,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1984.15,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1927.46,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1889.67,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1889.67,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal) ","code_information":[{"code":"L5654","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":377.07,"maximum":427.60,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":388.73,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":415.94,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":412.05,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":396.50,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":396.50,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":427.60,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":415.94,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":427.60,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":415.94,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":423.72,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":388.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":427.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":408.17,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":377.07,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":388.73,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":408.17,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":396.50,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":388.73,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":388.73,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, torsion control, straight knee joint, each joint ","code_information":[{"code":"L2380","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":131.39,"maximum":149.00,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":135.45,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":144.93,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":143.58,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":138.16,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":138.16,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":149.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":144.93,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":149.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":144.93,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":147.64,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":135.45,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":149.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":142.22,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":131.39,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":135.45,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":142.22,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":138.16,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":135.45,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":135.45,"methodology":"fee schedule"}]}]},{"description":"Addition to tlso, (low profile), lateral trochanteric pad ","code_information":[{"code":"L1290","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":106.64,"maximum":120.93,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":109.94,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":117.64,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":116.54,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":112.14,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":112.14,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":120.93,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":117.64,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":120.93,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":117.64,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":119.83,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":109.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":120.93,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":115.44,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":106.64,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":109.94,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":115.44,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":112.14,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":109.94,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":109.94,"methodology":"fee schedule"}]}]},{"description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material ","code_information":[{"code":"L7404","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":639.01,"maximum":724.65,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":658.77,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":704.88,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":698.30,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":671.95,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":671.95,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":724.65,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":704.88,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":724.65,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":704.88,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":718.06,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":658.77,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":724.65,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":691.71,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":639.01,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":658.77,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":691.71,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":671.95,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":658.77,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":658.77,"methodology":"fee schedule"}]}]},{"description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated ","code_information":[{"code":"L6895","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":711.40,"maximum":806.74,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":733.40,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":784.74,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":777.40,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":748.07,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":748.07,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":806.74,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":784.74,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":806.74,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":784.74,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":799.41,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":733.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":806.74,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":770.07,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":711.40,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":733.40,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":770.07,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":748.07,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":733.40,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":733.40,"methodology":"fee schedule"}]}]},{"description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control ","code_information":[{"code":"L5824","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1743.58,"maximum":1977.25,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1797.50,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1923.33,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1905.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1833.45,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1833.45,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1977.25,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1923.33,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1977.25,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1923.33,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1959.28,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1797.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1977.25,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1887.38,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1743.58,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1797.50,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1887.38,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1833.45,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1797.50,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1797.50,"methodology":"fee schedule"}]}]},{"description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system ","code_information":[{"code":"L5964","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1064.78,"maximum":1207.48,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1097.71,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1174.55,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1163.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1119.66,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1119.66,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1207.48,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1174.55,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1207.48,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1174.55,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1196.50,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1097.71,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1207.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1152.60,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1064.78,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1097.71,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1152.60,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1119.66,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1097.71,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1097.71,"methodology":"fee schedule"}]}]},{"description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) ","code_information":[{"code":"L5785","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":731.72,"maximum":829.79,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":754.35,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":807.15,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":799.61,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":769.44,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":769.44,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":829.79,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":807.15,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":829.79,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":807.15,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":822.24,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":754.35,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":829.79,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":792.07,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":731.72,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":754.35,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":792.07,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":769.44,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":754.35,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":754.35,"methodology":"fee schedule"}]}]},{"description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each ","code_information":[{"code":"A7506","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":0.43,"maximum":0.48,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":0.44,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":0.47,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":0.47,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":0.45,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":0.45,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":0.48,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":0.47,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":0.48,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":0.47,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":0.48,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":0.44,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":0.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":0.46,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":0.43,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":0.44,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":0.46,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":0.45,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":0.44,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":0.44,"methodology":"fee schedule"}]}]},{"description":"Adrenocorticotropic hormone (ACTH) ","code_information":[{"code":"684820","type":"CDM"},{"code":"82024","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":35.01,"maximum":45.96,"gross_charge":13.59,"discounted_cash":13.59,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":38.62,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":41.32,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":40.94,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":39.39,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":39.39,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":42.48,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":41.32,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":42.48,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":41.32,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":42.10,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":38.62,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":42.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":40.55,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":35.01,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":38.62,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":45.96,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":40.55,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":39.39,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":38.62,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":38.62,"methodology":"fee schedule"}]}]},{"description":"Aflibercept injection ","code_information":[{"code":"1420","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":821.98,"maximum":904.18,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":821.98,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":879.52,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":871.30,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":838.42,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":838.42,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":904.18,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":879.52,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":904.18,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":879.52,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":895.96,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":821.98,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":904.18,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":863.08,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":821.98,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":863.08,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":838.42,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":821.98,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":821.98,"methodology":"fee schedule"}]}]},{"description":"Albumin (human),5%, 50ml ","code_information":[{"code":"961","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":10.62,"maximum":11.68,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":10.62,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":11.36,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":11.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":10.83,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":10.83,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":11.68,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":11.36,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":11.68,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":11.36,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":11.57,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":10.62,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":11.68,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":11.15,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10.62,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":11.15,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":10.83,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":10.62,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":10.62,"methodology":"fee schedule"}]}]},{"description":"Aldosterone ","code_information":[{"code":"82088","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":36.94,"maximum":48.49,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":40.75,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":43.60,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":43.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":41.56,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":41.56,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":44.83,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":43.60,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":44.83,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":43.60,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":44.42,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":40.75,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":44.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":42.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":36.94,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":40.75,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":48.49,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":42.79,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":41.56,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":40.75,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":40.75,"methodology":"fee schedule"}]}]},{"description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot ","code_information":[{"code":"L5975","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":533.05,"maximum":604.49,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":549.54,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":588.01,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":582.51,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":560.53,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":560.53,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":604.49,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":588.01,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":604.49,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":588.01,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":599.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":549.54,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":604.49,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":577.02,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":533.05,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":549.54,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":577.02,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":560.53,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":549.54,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":549.54,"methodology":"fee schedule"}]}]},{"description":"Alpha-fetoprotein (AFP); amniotic fluid ","code_information":[{"code":"82106","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":15.40,"maximum":20.23,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":18.19,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":18.02,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17.34,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17.34,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":18.70,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":18.19,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":18.70,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":18.19,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":18.53,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":17.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":18.70,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":17.85,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":15.40,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":17.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":20.23,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":17.85,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":17.34,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":17.00,"methodology":"fee schedule"}]}]},{"description":"Amino acids; single, quantitative, each specimen ","code_information":[{"code":"82131","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":20.83,"maximum":27.35,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":22.98,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":24.59,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":24.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":23.44,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":23.44,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":25.28,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":24.59,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":25.28,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":24.59,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":25.05,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":22.98,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":25.28,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":24.13,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":20.83,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":22.98,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":27.35,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":24.13,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":23.44,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":22.98,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":22.98,"methodology":"fee schedule"}]}]},{"description":"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH ","code_information":[{"code":"617","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":112527.18,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":16956.31,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17125.87,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":18482.38,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":17973.69,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":31714.53,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":44183.74,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":31714.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17125.87,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17125.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":46686.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":112527.18,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":46686.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":31714.53,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":18651.94,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":30834.05,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":49251.78,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":17973.69,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":18482.38,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":16956.31,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":18482.38,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":16803.70,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":16447.62,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":17973.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":21195.39,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":16956.31,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":16956.31,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":16956.31,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16417.90,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18906.29,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":16956.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":16210.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":16956.31,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":16956.31,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":16617.18,"methodology":"fee schedule"}]}]},{"description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest ","code_information":[{"code":"E1172","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":110.23,"maximum":125.00,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":113.64,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":121.59,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":120.46,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":115.91,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":115.91,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":125.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":121.59,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":125.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":121.59,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":123.87,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":113.64,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":125.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":119.32,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":110.23,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":113.64,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":119.32,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":115.91,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":113.64,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":113.64,"methodology":"fee schedule"}]}]},{"description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment ","code_information":[{"code":"L2112","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":541.41,"maximum":613.97,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":558.15,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":597.22,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":591.64,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":569.31,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":569.31,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":613.97,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":597.22,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":613.97,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":597.22,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":608.38,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":558.15,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":613.97,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":586.06,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":541.41,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":558.15,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":586.06,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":569.31,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":558.15,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":558.15,"methodology":"fee schedule"}]}]},{"description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated ","code_information":[{"code":"L1945","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1047.71,"maximum":1188.12,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1080.11,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1155.72,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1144.92,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1101.71,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1101.71,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1188.12,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1155.72,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1188.12,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1155.72,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1177.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1080.11,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1188.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1134.12,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1047.71,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1080.11,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1134.12,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1101.71,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1080.11,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1080.11,"methodology":"fee schedule"}]}]},{"description":"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class ","code_information":[{"code":"86831","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":74.21,"maximum":97.44,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":81.88,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":87.61,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":86.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":83.52,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":83.52,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":90.07,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":87.61,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":90.07,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":87.61,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":81.88,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":90.07,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":85.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":74.21,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":81.88,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":97.44,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":85.97,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":83.52,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":81.88,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":81.88,"methodology":"fee schedule"}]}]},{"description":"Antibody; Blastomyces ","code_information":[{"code":"705424","type":"CDM"},{"code":"86612","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":11.69,"maximum":15.35,"gross_charge":141.10,"discounted_cash":141.10,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12.90,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13.80,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13.67,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":13.16,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":13.16,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":14.19,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13.80,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":14.19,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13.80,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":14.06,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":12.90,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14.19,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":13.55,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":11.69,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12.90,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":15.35,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":13.55,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":13.16,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12.90,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12.90,"methodology":"fee schedule"}]}]},{"description":"Antibody; Ehrlichia ","code_information":[{"code":"86666","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":9.22,"maximum":12.11,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":10.18,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":10.89,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":10.38,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":10.38,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":11.20,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10.89,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":11.20,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10.89,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":11.10,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":10.18,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":11.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":10.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":9.22,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10.18,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":12.11,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":10.69,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":10.38,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":10.18,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":10.18,"methodology":"fee schedule"}]}]},{"description":"Antibody; Haemophilus influenza ","code_information":[{"code":"86684","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":14.36,"maximum":18.85,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15.84,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16.95,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":16.16,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":16.16,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":17.42,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16.95,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":17.42,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16.95,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":17.27,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":15.84,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":17.42,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":16.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":14.36,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":15.84,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":18.85,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":16.63,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":16.16,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15.84,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15.84,"methodology":"fee schedule"}]}]},{"description":"Antibody; Legionella ","code_information":[{"code":"86713","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":13.87,"maximum":18.21,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15.30,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16.37,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16.22,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15.61,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15.61,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":16.83,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16.37,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":16.83,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16.37,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16.68,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":15.30,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":16.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":16.07,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":13.87,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":15.30,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":18.21,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":16.07,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15.61,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15.30,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15.30,"methodology":"fee schedule"}]}]},{"description":"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ","code_information":[{"code":"709689","type":"CDM"},{"code":"81201","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":780.00,"maximum":928.20,"gross_charge":7792.00,"discounted_cash":7792.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":780.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":834.60,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":826.80,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":795.60,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":795.60,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":858.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":834.60,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":858.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":834.60,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":850.20,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":780.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":858.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":819.00,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":780.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":928.20,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":819.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":795.60,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":780.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":780.00,"methodology":"fee schedule"}]}]},{"description":"Application of a modality to 1 or more areas; whirlpool ","code_information":[{"code":"97022","type":"CPT"}],"standard_charges":[{"modifiers":"GO|CO","modifiers_description":"Services delivered under an outpatient occupational therapy plan of care|Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant","setting":"outpatient","minimum":14.00,"maximum":15.40,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14.00,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":14.98,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":14.84,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14.28,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14.28,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15.40,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":14.98,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":15.40,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":14.98,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":15.26,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":14.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14.70,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":14.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":14.70,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14.28,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14.00,"methodology":"fee schedule"}]}]},{"description":"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ","code_information":[{"code":"81173","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":301.35,"maximum":358.61,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":301.35,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":322.44,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":319.43,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":307.38,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":307.38,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":331.49,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":322.44,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":331.49,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":322.44,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":328.47,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":301.35,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":331.49,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":316.42,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":301.35,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":358.61,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":316.42,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":307.38,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":301.35,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":301.35,"methodology":"fee schedule"}]}]},{"description":"ARTHROSCOPY ","code_information":[{"code":"509","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":44773.18,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":15454.82,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15609.37,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16845.75,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16382.11,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":6516.60,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":9078.74,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":6516.60,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15609.37,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15609.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":9593.05,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":23121.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":9593.05,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":6516.60,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":17000.30,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":28030.23,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":44773.18,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16382.11,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16845.75,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":15454.82,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16845.75,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15315.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14991.18,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":16382.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":19318.53,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":15454.82,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":15454.82,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":15454.82,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":14924.98,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":17232.12,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15454.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":14774.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15454.82,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":15454.82,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15145.72,"methodology":"fee schedule"}]}]},{"description":"ATHEROSCLEROSIS WITHOUT MCC ","code_information":[{"code":"303","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":24242.92,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":6190.32,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":6252.23,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6747.45,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6561.74,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":6832.60,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":9518.97,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":6832.60,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6252.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6252.23,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":10058.22,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":24242.92,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":10058.22,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":6832.60,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6809.35,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":10730.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":17139.48,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6561.74,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6747.45,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":6190.32,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6747.45,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6134.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6004.61,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":6561.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7737.90,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":6190.32,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":6190.32,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":6190.32,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5713.38,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6902.21,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6190.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":5917.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6190.32,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":6190.32,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6066.52,"methodology":"fee schedule"}]}]},{"description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each ","code_information":[{"code":"L8691","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1980.05,"maximum":2245.42,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2041.29,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2184.18,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2163.77,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2082.12,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2082.12,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2245.42,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2184.18,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2245.42,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2184.18,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2225.01,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2041.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2245.42,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2143.35,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1980.05,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2041.29,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2143.35,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2082.12,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2041.29,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2041.29,"methodology":"fee schedule"}]}]},{"description":"Azutoimmun IBD mRNA gen Xprsn PRFL 17 Gen Whl Bld ","code_information":[{"code":"0203U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":760.00,"maximum":904.40,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":760.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":813.20,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":805.60,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":775.20,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":775.20,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":836.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":813.20,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":836.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":813.20,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":828.40,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":760.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":836.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":798.00,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":760.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":904.40,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":798.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":775.20,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":760.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":760.00,"methodology":"fee schedule"}]}]},{"description":"Baclofen 10 MG injection ","code_information":[{"code":"9032","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":174.58,"maximum":192.04,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":174.58,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":186.80,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":185.06,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":178.07,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":178.07,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":192.04,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":186.80,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":192.04,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":186.80,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":190.29,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":174.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":192.04,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":183.31,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":174.58,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":183.31,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":178.07,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":174.58,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":174.58,"methodology":"fee schedule"}]}]},{"description":"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass ","code_information":[{"code":"691264","type":"CDM"},{"code":"80047","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":12.45,"maximum":16.34,"gross_charge":2146.54,"discounted_cash":2146.54,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":13.73,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":14.69,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":14.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14.00,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14.00,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15.10,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":14.69,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":15.10,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":14.69,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":14.97,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":13.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14.42,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":12.45,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":13.73,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16.34,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":14.42,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14.00,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":13.73,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":13.73,"methodology":"fee schedule"}]}]},{"description":"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ","code_information":[{"code":"81205","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":94.99,"maximum":113.04,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":94.99,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":101.64,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":100.69,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":96.89,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":96.89,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":104.49,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":101.64,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":104.49,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":101.64,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":103.54,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":94.99,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":104.49,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":99.74,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":94.99,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":113.04,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":99.74,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":96.89,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":94.99,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":94.99,"methodology":"fee schedule"}]}]},{"description":"Biofeedback training by any modality ","code_information":[{"code":"90901","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","minimum":33.71,"maximum":37.08,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":33.71,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":36.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":35.73,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":34.39,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":34.39,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":37.08,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":36.07,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":37.08,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":36.07,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":36.74,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":33.71,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":37.08,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":35.40,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":33.71,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":35.40,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":34.39,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":33.71,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":33.71,"methodology":"fee schedule"}]}]},{"description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ","code_information":[{"code":"85032","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3.91,"maximum":5.13,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4.31,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4.61,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4.40,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4.40,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.74,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4.61,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.74,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4.61,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.70,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4.31,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.74,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3.91,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4.31,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5.13,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4.53,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4.40,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4.31,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4.31,"methodology":"fee schedule"}]}]},{"description":"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ","code_information":[{"code":"704098","type":"CDM"},{"code":"86905","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3.83,"maximum":4.56,"gross_charge":311.91,"discounted_cash":311.91,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3.83,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4.10,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4.06,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3.91,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3.91,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.21,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4.10,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.21,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4.10,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.17,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.21,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4.02,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3.83,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":4.56,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4.02,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3.91,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3.83,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3.83,"methodology":"fee schedule"}]}]},{"description":"Brachytx, non-str, HDR Ir ","code_information":[{"code":"2646","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":346.98,"maximum":381.68,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":346.98,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":371.27,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":367.80,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":353.92,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":353.92,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":381.68,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":371.27,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":381.68,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":371.27,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":378.21,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":346.98,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":381.68,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":364.33,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":346.98,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":364.33,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":353.92,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":346.98,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":346.98,"methodology":"fee schedule"}]}]},{"description":"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ","code_information":[{"code":"81163","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":468.00,"maximum":556.92,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":468.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":500.76,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":496.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":477.36,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":477.36,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":514.80,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":500.76,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":514.80,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":500.76,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":510.12,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":468.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":514.80,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":491.40,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":468.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":556.92,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":491.40,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":477.36,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":468.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":468.00,"methodology":"fee schedule"}]}]},{"description":"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ","code_information":[{"code":"81233","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":175.40,"maximum":208.73,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":175.40,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":187.68,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":185.92,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":178.91,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":178.91,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":192.94,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":187.68,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":192.94,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":187.68,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":191.19,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":175.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":192.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":184.17,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":175.40,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":208.73,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":184.17,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":178.91,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":175.40,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":175.40,"methodology":"fee schedule"}]}]},{"description":"Cadmium ","code_information":[{"code":"82300","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":21.43,"maximum":28.13,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":23.64,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":25.29,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":25.06,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":24.11,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":24.11,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":26.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":25.29,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":26.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":25.29,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":25.77,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":23.64,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":26.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":24.82,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":21.43,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":23.64,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":28.13,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":24.82,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":24.11,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":23.64,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":23.64,"methodology":"fee schedule"}]}]},{"description":"Canister, non-disposable, used with suction pump, each ","code_information":[{"code":"A7001","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":37.21,"maximum":42.20,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":38.36,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":41.05,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":40.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":39.13,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":39.13,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":42.20,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":41.05,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":42.20,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":41.05,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":41.81,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":38.36,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":42.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":40.28,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":37.21,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":38.36,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":40.28,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":39.13,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":38.36,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":38.36,"methodology":"fee schedule"}]}]},{"description":"CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC ","code_information":[{"code":"307","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":25879.98,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":8360.10,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8443.70,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":9112.51,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8861.70,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":7293.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":10161.76,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":7293.98,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8443.70,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8443.70,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":10737.42,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":25879.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":10737.42,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":7293.98,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":9196.11,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":14781.90,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":23611.39,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8861.70,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":9112.51,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":8360.10,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":9112.51,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8284.86,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8109.30,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":8861.70,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10450.12,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":8360.10,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":8360.10,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":8360.10,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7870.77,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9321.51,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8360.10,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":7992.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8360.10,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":8360.10,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8192.90,"methodology":"fee schedule"}]}]},{"description":"Cast supplies, long leg cast, adult (11 years +), fiberglass ","code_information":[{"code":"Q4030","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":90.01,"maximum":102.07,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":92.79,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":99.29,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":98.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":94.65,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":94.65,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":102.07,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":99.29,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":102.07,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":99.29,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":101.14,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":92.79,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":102.07,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":97.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":90.01,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":92.79,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":97.43,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":94.65,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":92.79,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":92.79,"methodology":"fee schedule"}]}]},{"description":"Cast supplies, shoulder cast, adult (11 years +), plaster ","code_information":[{"code":"Q4003","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":41.58,"maximum":47.16,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":42.87,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":45.87,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":45.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":43.73,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":43.73,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":47.16,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":45.87,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":47.16,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":45.87,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":46.73,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":42.87,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":47.16,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":45.01,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":41.58,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":42.87,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":45.01,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":43.73,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":42.87,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":42.87,"methodology":"fee schedule"}]}]},{"description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf ","code_information":[{"code":"L0172","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":163.18,"maximum":185.05,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":168.23,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":180.01,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":178.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":171.59,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":171.59,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":185.05,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":180.01,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":185.05,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":180.01,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":183.37,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":168.23,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":185.05,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":176.64,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":163.18,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":168.23,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":176.64,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":171.59,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":168.23,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":168.23,"methodology":"fee schedule"}]}]},{"description":"Cervical, semi-rigid, adjustable (plastic collar) ","code_information":[{"code":"L0140","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":80.10,"maximum":90.84,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":82.58,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":88.36,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":87.53,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":84.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":84.23,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":90.84,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":88.36,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":90.84,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":88.36,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":90.01,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":82.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":90.84,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":86.71,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":80.10,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":82.58,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":86.71,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":84.23,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":82.58,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":82.58,"methodology":"fee schedule"}]}]},{"description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type) ","code_information":[{"code":"L0700","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":2470.61,"maximum":2801.72,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2547.02,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2725.31,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2699.84,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2597.96,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2597.96,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2801.72,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2725.31,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2801.72,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2725.31,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2776.25,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2547.02,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2801.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2674.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":2470.61,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2547.02,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2674.37,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2597.96,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2547.02,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2547.02,"methodology":"fee schedule"}]}]},{"description":"Cetuximab injection ","code_information":[{"code":"9215","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":75.48,"maximum":83.03,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":75.48,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":80.76,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":80.01,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":76.99,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":76.99,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":83.03,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":80.76,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":83.03,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":80.76,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":82.27,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":75.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":83.03,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":79.25,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":75.48,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":79.25,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":76.99,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":75.48,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":75.48,"methodology":"fee schedule"}]}]},{"description":"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ","code_information":[{"code":"685098","type":"CDM"},{"code":"88263","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":136.22,"maximum":178.85,"gross_charge":2118.49,"discounted_cash":2118.49,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":150.29,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":160.81,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":159.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":153.30,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":153.30,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":165.32,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":160.81,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":165.32,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":160.81,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":163.82,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":150.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":165.32,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":157.80,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":136.22,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":150.29,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":178.85,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":157.80,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":153.30,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":150.29,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":150.29,"methodology":"fee schedule"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC ","code_information":[{"code":"192","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":37033.31,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":5974.97,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":6034.72,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6512.72,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6333.47,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":10437.42,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":14541.11,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":10437.42,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6034.72,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6034.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":15364.86,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":37033.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":15364.86,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":10437.42,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6572.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":10328.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":16497.13,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6333.47,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6512.72,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":5974.97,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6512.72,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5921.19,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5795.72,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":6333.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7468.71,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":5974.97,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":5974.97,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":5974.97,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5499.26,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6662.09,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5974.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":5712.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5974.97,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":5974.97,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5855.47,"methodology":"fee schedule"}]}]},{"description":"Clotting; factor II, prothrombin, specific ","code_information":[{"code":"685401","type":"CDM"},{"code":"85210","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":11.77,"maximum":15.45,"gross_charge":15.00,"discounted_cash":15.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12.98,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13.89,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":13.24,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":13.24,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":14.28,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13.89,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":14.28,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13.89,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":14.15,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":12.98,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14.28,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":13.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":11.77,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12.98,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":15.45,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":13.63,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":13.24,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12.98,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12.98,"methodology":"fee schedule"}]}]},{"description":"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ","code_information":[{"code":"85397","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":27.97,"maximum":36.72,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":30.86,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":33.02,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":32.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":31.48,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":31.48,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":33.95,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":33.02,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":33.95,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":33.02,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":33.64,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":30.86,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":33.95,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":32.40,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":27.97,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":30.86,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":36.72,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":32.40,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":31.48,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":30.86,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":30.86,"methodology":"fee schedule"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC ","code_information":[{"code":"144","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":44775.73,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":15455.67,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15610.23,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16846.68,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16383.01,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":34636.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":16709.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":31803.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":11261.33,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":15688.95,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":11261.33,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15610.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15610.23,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":16577.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":39956.63,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":16577.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":11261.33,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":17001.24,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":28031.82,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":44775.73,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16383.01,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16846.68,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":15455.67,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16846.68,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15316.57,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14992.00,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":16383.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":19319.59,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":15455.67,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":15455.67,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":15455.67,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":14925.83,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":17233.07,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15455.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":14775.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15455.67,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":15455.67,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15146.56,"methodology":"fee schedule"}]}]},{"description":"OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC ","code_information":[{"code":"319","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":89320.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":37981.53,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":55923.00,"methodology":"case rate"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":38361.35,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":55923.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_dollar":31098.00,"methodology":"case rate"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":41399.87,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":40260.42,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":57147.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":29073.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":52472.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":16467.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":22941.95,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":16467.44,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":38361.35,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":38361.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":24241.60,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":58428.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":24241.60,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":16467.44,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":41779.68,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":36793.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":45924.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":40260.42,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":41399.87,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":37981.53,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":41399.87,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":37639.70,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":36842.08,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":40260.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":47476.91,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":37981.53,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":37981.53,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":37981.53,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":37323.07,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":42349.41,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":37981.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":89320.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":36310.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":66751.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":37981.53,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":37981.53,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":37221.90,"methodology":"fee schedule"}]}]},{"description":"OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC ","code_information":[{"code":"716","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":38567.19,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":12572.32,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12698.04,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13703.83,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13326.66,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":10869.73,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":15143.39,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":10869.73,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":12698.04,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":12698.04,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":16001.26,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":38567.19,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":16001.26,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":10869.73,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":13829.55,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":22647.59,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":36175.41,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13326.66,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13703.83,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":12572.32,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13703.83,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":12459.17,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":12195.15,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":13326.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":15715.40,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":12572.32,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":12572.32,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":12572.32,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":12058.94,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":14018.14,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":12572.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":12019.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12572.32,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":12572.32,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12320.87,"methodology":"fee schedule"}]}]},{"description":"OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC ","code_information":[{"code":"963","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":69246.13,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":23659.63,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":23896.23,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":25789.00,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":25079.21,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":17761.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":24744.73,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":17761.45,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":23896.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":23896.23,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":26146.52,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":63019.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":26146.52,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":17761.45,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":26025.59,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":43351.50,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":69246.13,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":25079.21,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":25789.00,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":23659.63,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":25789.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":23446.69,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":22949.84,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":25079.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":29574.54,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":23659.63,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":23659.63,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":23659.63,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":23082.95,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":26380.49,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":23659.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":22618.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":23659.63,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":23659.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":23186.44,"methodology":"fee schedule"}]}]},{"description":"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC ","code_information":[{"code":"517","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":49364.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":13199.58,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":13331.58,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":14387.54,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13991.55,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":49364.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":23815.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":45326.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":9224.83,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":12851.76,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":9224.83,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":13331.58,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":13331.58,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":13579.81,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":32730.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":13579.81,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":9224.83,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":14519.54,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":23818.91,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":38046.37,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13991.55,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":14387.54,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":13199.58,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":14387.54,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14849.53,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":12803.59,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":13991.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":16499.47,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":13199.58,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":13199.58,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":13199.58,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":12682.62,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":14717.53,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":13199.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":48159.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":12618.80,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":35990.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":13199.58,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":13199.58,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12935.59,"methodology":"fee schedule"}]}]},{"description":"OTHER O.R. PROCEDURES FOR INJURIES WITH MCC ","code_information":[{"code":"907","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":101539.41,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":34486.30,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":34831.16,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":37590.07,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":36555.48,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":17586.01,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":24500.31,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":17586.01,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":34831.16,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":34831.16,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":25888.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":62397.41,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":25888.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":17586.01,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":37934.93,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":63568.69,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":101539.41,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":36555.48,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":37590.07,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":34486.30,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":37590.07,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":34175.92,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":33451.71,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":36555.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":43107.88,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":34486.30,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":34486.30,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":34486.30,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":33847.80,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":38452.22,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":34486.30,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":32968.90,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":34486.30,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":34486.30,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":33796.57,"methodology":"fee schedule"}]}]},{"description":"OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC ","code_information":[{"code":"168","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":57551.57,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":12013.43,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12133.56,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13094.64,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":12734.24,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":16220.27,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":22597.59,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":16220.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":12133.56,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":12133.56,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":23877.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":57551.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":23877.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":16220.27,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":13214.77,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":21603.94,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":34508.36,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":12734.24,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13094.64,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":12013.43,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13094.64,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":11905.31,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":11653.03,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":12734.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":15016.79,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":12013.43,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":12013.43,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":12013.43,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":11503.24,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":13394.97,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":12013.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":11484.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12013.43,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":12013.43,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":11773.16,"methodology":"fee schedule"}]}]},{"description":"Oxalate ","code_information":[{"code":"685973","type":"CDM"},{"code":"83945","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":13.09,"maximum":17.20,"gross_charge":9.00,"discounted_cash":9.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14.45,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":15.46,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":15.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14.74,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14.74,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15.90,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":15.46,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":15.90,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":15.46,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":15.75,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":14.45,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15.90,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":15.17,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":13.09,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":14.45,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":17.20,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":15.17,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14.74,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14.45,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14.45,"methodology":"fee schedule"}]}]},{"description":"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ","code_information":[{"code":"81312","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":137.00,"maximum":163.03,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":137.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":146.59,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":145.22,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":139.74,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":139.74,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":150.70,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":146.59,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":150.70,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":146.59,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":149.33,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":137.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":150.70,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":143.85,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":137.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":163.03,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":143.85,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":139.74,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":137.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":137.00,"methodology":"fee schedule"}]}]},{"description":"Particle agglutination; screen, each antibody ","code_information":[{"code":"86403","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":10.46,"maximum":13.73,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":11.54,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":12.35,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":12.23,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":11.77,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":11.77,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":12.69,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":12.35,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":12.69,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":12.35,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":12.58,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":11.54,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":12.69,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":12.12,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":10.46,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":11.54,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":13.73,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":12.12,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":11.77,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":11.54,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":11.54,"methodology":"fee schedule"}]}]},{"description":"Penicillin g benzathine i ","code_information":[{"code":"1829","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":24.37,"maximum":26.80,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":24.37,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":26.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":25.83,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":24.86,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":24.86,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":26.80,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":26.07,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":26.80,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":26.07,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":26.56,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":24.37,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":26.80,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":25.59,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":24.37,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":25.59,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":24.86,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":24.37,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":24.37,"methodology":"fee schedule"}]}]},{"description":"PERIPHERAL VASCULAR DISORDERS WITH CC ","code_information":[{"code":"300","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":68872.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":9592.40,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":39808.00,"methodology":"case rate"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":9688.33,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":39808.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_dollar":22136.00,"methodology":"case rate"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":10455.72,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10167.95,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":48833.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":21417.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":44840.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":7997.69,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":11142.15,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":7997.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":9688.33,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":9688.33,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":11773.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":28376.84,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":11773.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":7997.69,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":10551.64,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":32381.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":68872.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10167.95,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10455.72,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":9592.40,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":10455.72,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":9506.07,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9304.63,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":10167.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":11990.50,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":9592.40,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":9592.40,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":9592.40,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":9096.04,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":10695.53,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":9592.40,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":17086.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":9170.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12769.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":9592.40,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":9592.40,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":9400.55,"methodology":"fee schedule"}]}]},{"description":"Pessary, reusable, non rubber, any type ","code_information":[{"code":"A4562","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":67.75,"maximum":76.83,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":69.85,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":74.74,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":74.04,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":71.25,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":71.25,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":76.83,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":74.74,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":76.83,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":74.74,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":76.14,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":69.85,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":76.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":73.34,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":67.75,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":69.85,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":73.34,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":71.25,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":69.85,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":69.85,"methodology":"fee schedule"}]}]},{"description":"Phosphatase, alkaline; ","code_information":[{"code":"684055","type":"CDM"},{"code":"84075","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":4.69,"maximum":6.16,"gross_charge":1310.43,"discounted_cash":1310.43,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5.18,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":5.54,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":5.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5.28,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5.28,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":5.70,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":5.54,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":5.70,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":5.54,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":5.65,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5.18,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5.70,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5.44,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4.69,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5.18,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":6.16,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":5.44,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5.28,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5.18,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5.18,"methodology":"fee schedule"}]}]},{"description":"Phosphogluconate, 6-, dehydrogenase, RBC ","code_information":[{"code":"84085","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":8.56,"maximum":11.23,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":9.44,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":10.10,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10.01,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":9.63,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":9.63,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":10.38,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10.10,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":10.38,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10.10,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":10.29,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":9.44,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":10.38,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9.91,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":8.56,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":9.44,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":11.23,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9.91,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":9.63,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":9.44,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":9.44,"methodology":"fee schedule"}]}]},{"description":"Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination o ","code_information":[{"code":"97162","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","minimum":83.27,"maximum":91.59,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":83.27,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":89.09,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":88.26,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":84.93,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":84.93,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":91.59,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":89.09,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":91.59,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":89.09,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":90.76,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":83.27,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":91.59,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":87.43,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":83.27,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":87.43,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":84.93,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":83.27,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":83.27,"methodology":"fee schedule"}]}]},{"description":"Plasma protein fract,5%,5 ","code_information":[{"code":"9514","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":7.95,"maximum":8.75,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7.95,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":8.51,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8.43,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8.11,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8.11,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8.75,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8.51,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":8.75,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":8.51,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8.67,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":7.95,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8.75,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8.35,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7.95,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8.35,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8.11,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":7.95,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7.95,"methodology":"fee schedule"}]}]},{"description":"Platelets leukoreduced ir ","code_information":[{"code":"9521","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":230.63,"maximum":253.69,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":230.63,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":246.77,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":244.47,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":235.24,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":235.24,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":253.69,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":246.77,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":253.69,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":246.77,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":251.39,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":230.63,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":253.69,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":242.16,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":230.63,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":242.16,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":235.24,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":230.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":230.63,"methodology":"fee schedule"}]}]},{"description":"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ","code_information":[{"code":"81317","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":676.50,"maximum":805.03,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":676.50,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":723.86,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":717.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":690.03,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":690.03,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":744.15,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":723.86,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":744.15,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":723.86,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":737.39,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":676.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":744.15,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":710.33,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":676.50,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":805.03,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":710.33,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":690.03,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":676.50,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":676.50,"methodology":"fee schedule"}]}]},{"description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing ","code_information":[{"code":"E0434","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":43.96,"maximum":49.85,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":45.32,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":48.49,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":48.04,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":46.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":46.23,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":49.85,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":48.49,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":49.85,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":48.49,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":49.40,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":45.32,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":49.85,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":47.59,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":43.96,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":45.32,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":47.59,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":46.23,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":45.32,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":45.32,"methodology":"fee schedule"}]}]},{"description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware ","code_information":[{"code":"E2616","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":533.44,"maximum":604.93,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":549.94,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":588.44,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":582.94,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":560.94,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":560.94,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":604.93,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":588.44,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":604.93,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":588.44,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":599.43,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":549.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":604.93,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":577.44,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":533.44,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":549.94,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":577.44,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":560.94,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":549.94,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":549.94,"methodology":"fee schedule"}]}]},{"description":"POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC ","code_information":[{"code":"862","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":46865.91,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":16156.43,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":16317.99,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":17610.51,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":17125.82,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":9714.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":13533.71,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":9714.32,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":16317.99,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":16317.99,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":14300.39,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":34467.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":14300.39,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":9714.32,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":17772.07,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":29340.38,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":46865.91,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":17125.82,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":17610.51,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":16156.43,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":17610.51,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":16011.02,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":15671.74,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":17125.82,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":20195.54,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":16156.43,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":16156.43,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":16156.43,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":15622.58,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18014.42,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":16156.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":15445.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":16156.43,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":16156.43,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15833.30,"methodology":"fee schedule"}]}]},{"description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each ","code_information":[{"code":"E2367","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":420.93,"maximum":477.35,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":433.95,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":464.33,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":459.99,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":442.63,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":442.63,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":477.35,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":464.33,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":477.35,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":464.33,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":473.01,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":433.95,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":477.35,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":455.65,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":420.93,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":433.95,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":455.65,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":442.63,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":433.95,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":433.95,"methodology":"fee schedule"}]}]},{"description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection ","code_information":[{"code":"E2310","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":124.44,"maximum":141.12,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":128.29,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":137.27,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":135.99,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":130.86,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":130.86,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":141.12,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":137.27,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":141.12,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":137.27,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":139.84,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":128.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":141.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":134.70,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":124.44,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":128.29,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":134.70,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":130.86,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":128.29,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":128.29,"methodology":"fee schedule"}]}]},{"description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each ","code_information":[{"code":"E2388","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":54.58,"maximum":61.90,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":56.27,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":60.21,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":59.65,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":57.40,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":57.40,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":61.90,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":60.21,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":61.90,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":60.21,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":61.33,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":56.27,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":61.90,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":59.08,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":54.58,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":56.27,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":59.08,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":57.40,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":56.27,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":56.27,"methodology":"fee schedule"}]}]},{"description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware ","code_information":[{"code":"E2327","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":297.99,"maximum":337.93,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":307.21,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":328.71,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":325.64,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":313.35,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":313.35,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":337.93,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":328.71,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":337.93,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":328.71,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":334.86,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":307.21,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":337.93,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":322.57,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":297.99,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":307.21,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":322.57,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":313.35,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":307.21,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":307.21,"methodology":"fee schedule"}]}]},{"description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches ","code_information":[{"code":"E2340","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":474.28,"maximum":537.85,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":488.95,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":523.18,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":518.29,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":498.73,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":498.73,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":537.85,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":523.18,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":537.85,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":523.18,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":532.96,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":488.95,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":537.85,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":513.40,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":474.28,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":488.95,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":513.40,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":498.73,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":488.95,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":488.95,"methodology":"fee schedule"}]}]},{"description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each ","code_information":[{"code":"E2385","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":50.16,"maximum":56.88,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":51.71,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":55.33,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":54.81,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":52.74,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":52.74,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":56.88,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":55.33,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":56.88,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":55.33,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":56.36,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":51.71,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":56.88,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":54.30,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":50.16,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":51.71,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":54.30,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":52.74,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":51.71,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":51.71,"methodology":"fee schedule"}]}]},{"description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds ","code_information":[{"code":"K0815","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":343.48,"maximum":389.51,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":354.10,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":378.89,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":375.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":361.18,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":361.18,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":389.51,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":378.89,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":389.51,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":378.89,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":385.97,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":354.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":389.51,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":371.81,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":343.48,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":354.10,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":371.81,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":361.18,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":354.10,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":354.10,"methodology":"fee schedule"}]}]},{"description":"Powered air flotation bed (low air loss therapy) ","code_information":[{"code":"E0193","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":793.04,"maximum":899.33,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":817.57,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":874.80,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":866.62,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":833.92,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":833.92,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":899.33,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":874.80,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":899.33,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":874.80,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":891.15,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":817.57,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":899.33,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":858.45,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":793.04,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":817.57,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":858.45,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":833.92,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":817.57,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":817.57,"methodology":"fee schedule"}]}]},{"description":"Pregnenolone ","code_information":[{"code":"686108","type":"CDM"},{"code":"84140","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":18.73,"maximum":24.60,"gross_charge":26.23,"discounted_cash":26.23,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":20.67,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":22.12,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":21.91,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":21.08,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":21.08,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":22.74,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":22.12,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":22.74,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":22.12,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":22.53,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":20.67,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":22.74,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":21.70,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":18.73,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":20.67,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":24.60,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":21.70,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":21.08,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":20.67,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":20.67,"methodology":"fee schedule"}]}]},{"description":"Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model ","code_information":[{"code":"L5530","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1963.77,"maximum":2226.96,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2024.51,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2166.23,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2145.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2065.00,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2065.00,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2226.96,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2166.23,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2226.96,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2166.23,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2206.72,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2024.51,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2226.96,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2125.74,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1963.77,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2024.51,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2125.74,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2065.00,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2024.51,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2024.51,"methodology":"fee schedule"}]}]},{"description":"Procainamide; ","code_information":[{"code":"80190","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":54.38,"maximum":71.40,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":60.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":64.20,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":63.60,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":61.20,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":61.20,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":66.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":64.20,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":66.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":64.20,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":65.40,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":60.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":66.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":63.00,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":54.38,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":60.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":71.40,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":63.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":61.20,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":60.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":60.00,"methodology":"fee schedule"}]}]},{"description":"Prostaglandin, each ","code_information":[{"code":"84150","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":37.86,"maximum":49.71,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":41.77,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":44.69,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":44.28,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":42.61,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":42.61,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":45.95,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":44.69,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":45.95,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":44.69,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":45.53,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":41.77,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":45.95,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":43.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":37.86,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":41.77,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":49.71,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":43.86,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":42.61,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":41.77,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":41.77,"methodology":"fee schedule"}]}]},{"description":"Prosthetic sheath, above knee, each ","code_information":[{"code":"L8410","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":24.51,"maximum":27.80,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":25.27,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":27.04,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":26.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":25.78,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":25.78,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":27.80,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":27.04,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":27.80,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":27.04,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":27.54,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":25.27,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":27.80,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":26.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":24.51,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":25.27,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":26.53,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":25.78,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":25.27,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":25.27,"methodology":"fee schedule"}]}]},{"description":"Protein, total, except by refractometry; urine ","code_information":[{"code":"681045","type":"CDM"},{"code":"84156","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3.33,"maximum":4.37,"gross_charge":1033.34,"discounted_cash":1033.34,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3.67,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3.93,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3.74,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3.74,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.04,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3.93,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.04,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3.93,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3.67,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.04,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3.85,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3.33,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3.67,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":4.37,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3.85,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3.74,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3.67,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3.67,"methodology":"fee schedule"}]}]},{"description":"Quantitation of therapeutic drug, not elsewhere specified ","code_information":[{"code":"80299","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":16.90,"maximum":22.18,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":19.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":20.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19.57,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.90,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":22.18,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19.57,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18.64,"methodology":"fee schedule"}]}]},{"description":"Radiation treatment deliv ","code_information":[{"code":"4013","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":213.00,"maximum":234.30,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":213.00,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":227.91,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":225.78,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":217.26,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":217.26,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":234.30,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":227.91,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":234.30,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":227.91,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":232.17,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":213.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":234.30,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":223.65,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":213.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":223.65,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":217.26,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":213.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":213.00,"methodology":"fee schedule"}]}]},{"description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole g ","code_information":[{"code":"0267U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":6739.33,"maximum":8019.80,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":6739.33,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":7211.08,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7143.69,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6874.12,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6874.12,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7413.26,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":7211.08,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":7413.26,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7211.08,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7345.87,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":6739.33,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7413.26,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7076.30,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":6739.33,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":8019.80,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":7076.30,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6874.12,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6739.33,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6739.33,"methodology":"fee schedule"}]}]},{"description":"RBC, frz/deg/wsh, l/r, ir ","code_information":[{"code":"9532","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":492.70,"maximum":541.97,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":492.70,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":527.19,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":522.26,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":502.55,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":502.55,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":541.97,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":527.19,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":541.97,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":527.19,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":537.04,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":492.70,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":541.97,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":517.34,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":492.70,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":517.34,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":502.55,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":492.70,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":492.70,"methodology":"fee schedule"}]}]},{"description":"Re-evaluation of physical therapy established plan of care, requiring these components: An examination including a review of history and use of standardized tests and measures is required; and Revised ","code_information":[{"code":"97164","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","minimum":57.66,"maximum":63.43,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":57.66,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":61.70,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":61.12,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":58.82,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":58.82,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":63.43,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":61.70,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":63.43,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":61.70,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":62.85,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":57.66,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":63.43,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":60.55,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":57.66,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":60.55,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":58.82,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":57.66,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":57.66,"methodology":"fee schedule"}]}]},{"description":"Red cell antigen (colton blood group) genotyping (CO), gene analysis, AQP1 (aquaporin 1) exon 1 ","code_information":[{"code":"0181U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":185.20,"maximum":220.39,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":185.20,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":198.16,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":196.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":188.90,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":188.90,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":203.72,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":198.16,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":203.72,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":198.16,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":201.87,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":185.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":203.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":194.46,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":185.20,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":220.39,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":194.46,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":188.90,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":185.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":185.20,"methodology":"fee schedule"}]}]},{"description":"Red cell antigen (Lutheran blood group) genotyping (LU), gene analysis, BCAM (basal cell adhesion molecule) exon 3 ","code_information":[{"code":"0196U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":185.20,"maximum":220.39,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":185.20,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":198.16,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":196.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":188.90,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":188.90,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":203.72,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":198.16,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":203.72,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":198.16,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":201.87,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":185.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":203.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":194.46,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":185.20,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":220.39,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":194.46,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":188.90,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":185.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":185.20,"methodology":"fee schedule"}]}]},{"description":"Replace metal bands kafo, proximal thigh ","code_information":[{"code":"L4080","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":114.07,"maximum":129.36,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":117.60,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":125.83,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":124.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":119.95,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":119.95,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":129.36,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":125.83,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":129.36,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":125.83,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":128.18,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":117.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":129.36,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":123.48,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":114.07,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":117.60,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":123.48,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":119.95,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":117.60,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":117.60,"methodology":"fee schedule"}]}]},{"description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model ","code_information":[{"code":"L5701","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":3912.11,"maximum":4436.41,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4033.10,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4315.42,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4275.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4113.76,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4113.76,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4436.41,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4315.42,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4436.41,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4315.42,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4396.08,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4033.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4436.41,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4234.76,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3912.11,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4033.10,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4234.76,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4113.76,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4033.10,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4033.10,"methodology":"fee schedule"}]}]},{"description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive a ","code_information":[{"code":"E0470","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":122.82,"maximum":139.28,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":126.62,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":135.48,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":134.22,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":129.15,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":129.15,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":139.28,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":135.48,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":139.28,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":135.48,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":138.02,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":126.62,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":139.28,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":132.95,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":122.82,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":126.62,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":132.95,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":129.15,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":126.62,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":126.62,"methodology":"fee schedule"}]}]},{"description":"Reteplase injection ","code_information":[{"code":"9005","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":2777.14,"maximum":3054.85,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2777.14,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2971.54,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2943.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2832.68,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2832.68,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3054.85,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2971.54,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3054.85,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2971.54,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3027.08,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2777.14,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3054.85,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2915.99,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2777.14,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2915.99,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2832.68,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2777.14,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2777.14,"methodology":"fee schedule"}]}]},{"description":"Rsv mab im 50mg ","code_information":[{"code":"9003","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":339.68,"maximum":373.65,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":339.68,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":363.46,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":360.06,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":346.47,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":346.47,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":373.65,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":363.46,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":373.65,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":363.46,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":370.25,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":339.68,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":373.65,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":356.66,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":339.68,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":356.66,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":346.47,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":339.68,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":339.68,"methodology":"fee schedule"}]}]},{"description":"Seat attachment, walker ","code_information":[{"code":"E0156","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":18.41,"maximum":20.88,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":18.98,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":20.31,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":20.12,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19.36,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19.36,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":20.88,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":20.31,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":20.88,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":20.31,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":20.69,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":18.98,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":20.88,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19.93,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":18.41,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.98,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19.93,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19.36,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18.98,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18.98,"methodology":"fee schedule"}]}]},{"description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg ","code_information":[{"code":"E0669","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":230.38,"maximum":261.25,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":237.50,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":254.13,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":242.25,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":242.25,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":254.13,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":254.13,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":258.88,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":237.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":249.38,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":230.38,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":237.50,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":249.38,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":242.25,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":237.50,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":237.50,"methodology":"fee schedule"}]}]},{"description":"Sex hormone binding globulin (SHBG) ","code_information":[{"code":"686246","type":"CDM"},{"code":"84270","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":19.69,"maximum":25.86,"gross_charge":318.51,"discounted_cash":318.51,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":21.73,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":23.25,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":23.03,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":22.16,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":22.16,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":23.90,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":23.25,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":23.90,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":23.25,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":23.69,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":21.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":23.90,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":22.82,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":19.69,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":21.73,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":25.86,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":22.82,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":22.16,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":21.73,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":21.73,"methodology":"fee schedule"}]}]},{"description":"Shock absorber for power wheelchair, each ","code_information":[{"code":"E1016","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":122.43,"maximum":138.84,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":126.22,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":135.06,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":133.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":128.74,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":128.74,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":138.84,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":135.06,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":138.84,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":135.06,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":137.58,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":126.22,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":138.84,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":132.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":122.43,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":126.22,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":132.53,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":128.74,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":126.22,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":126.22,"methodology":"fee schedule"}]}]},{"description":"SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC ","code_information":[{"code":"555","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":34322.29,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":11951.04,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12070.55,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13026.63,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":12668.10,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":5615.15,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":7822.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":5615.15,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":12070.55,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":12070.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":8266.03,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":19923.29,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":8266.03,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":5615.15,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":13146.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":21487.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":34322.29,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":12668.10,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13026.63,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":11951.04,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13026.63,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":11843.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":11592.51,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":12668.10,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":14938.80,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":11951.04,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":11951.04,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":11951.04,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":11441.21,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":13325.41,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":11951.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":11425.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":11951.04,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":11951.04,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":11712.02,"methodology":"fee schedule"}]}]},{"description":"SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS ","code_information":[{"code":"019","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":202051.58,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":68184.08,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":68865.92,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":74320.65,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 11. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":72275.12,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 11. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":68865.92,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":68865.92,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":75002.49,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":126494.28,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":202051.58,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":72275.12,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":74320.65,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 11. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":68184.08,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":74320.65,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":67570.42,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":66138.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":72275.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":85230.10,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":68184.08,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":68184.08,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":68184.08,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":67353.17,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":76025.25,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":68184.08,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":68184.08,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":68184.08,"methodology":"fee schedule"}]}]},{"description":"Skin barrier; solid, 8 x 8 or equivalent, each ","code_information":[{"code":"A5122","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":16.99,"maximum":19.27,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17.52,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":18.75,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":18.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17.87,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17.87,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19.27,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":18.75,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":19.27,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":18.75,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":19.10,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":17.52,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":19.27,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":18.40,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.99,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":17.52,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18.40,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":17.87,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17.52,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":17.52,"methodology":"fee schedule"}]}]},{"description":"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ","code_information":[{"code":"87206","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":4.89,"maximum":6.41,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5.39,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":5.77,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":5.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5.50,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5.50,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":5.93,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":5.77,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":5.93,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":5.77,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":5.88,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5.39,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5.93,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5.66,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4.89,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5.39,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":6.41,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":5.66,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5.50,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5.39,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5.39,"methodology":"fee schedule"}]}]},{"description":"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ","code_information":[{"code":"81336","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":301.35,"maximum":358.61,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":301.35,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":322.44,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":319.43,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":307.38,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":307.38,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":331.49,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":322.44,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":331.49,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":322.44,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":328.47,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":301.35,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":331.49,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":316.42,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":301.35,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":358.61,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":316.42,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":307.38,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":301.35,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":301.35,"methodology":"fee schedule"}]}]},{"description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp ","code_information":[{"code":"81455","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":2919.60,"maximum":3474.32,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2919.60,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3123.97,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3094.78,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2977.99,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2977.99,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3211.56,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3123.97,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3211.56,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3123.97,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3182.36,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2919.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3211.56,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3065.58,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2919.60,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":3474.32,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3065.58,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2977.99,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2919.60,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2919.60,"methodology":"fee schedule"}]}]},{"description":"Somatropin injection ","code_information":[{"code":"9319","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":163.55,"maximum":179.91,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":163.55,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":175.00,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":173.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":166.82,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":166.82,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":179.91,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":175.00,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":179.91,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":175.00,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":178.27,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":163.55,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":179.91,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":171.73,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":163.55,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":171.73,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":166.82,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":163.55,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":163.55,"methodology":"fee schedule"}]}]},{"description":"Spectrophotometry, analyte not elsewhere specified ","code_information":[{"code":"84311","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":7.34,"maximum":9.64,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8.10,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":8.67,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8.59,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8.26,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8.26,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8.91,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8.67,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":8.91,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":8.67,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8.83,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":8.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8.91,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8.51,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":7.34,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8.10,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":9.64,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8.51,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8.26,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8.10,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8.10,"methodology":"fee schedule"}]}]},{"description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens ","code_information":[{"code":"V2302","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":96.16,"maximum":109.04,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":99.13,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":106.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":105.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":101.11,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":101.11,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":109.04,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":106.07,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":109.04,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":106.07,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":108.05,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":99.13,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":109.04,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":104.09,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":96.16,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":99.13,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":104.09,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":101.11,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":99.13,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":99.13,"methodology":"fee schedule"}]}]},{"description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens ","code_information":[{"code":"V2211","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":86.84,"maximum":98.48,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":89.53,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":95.80,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":94.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":91.32,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":91.32,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":98.48,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":95.80,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":98.48,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":95.80,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":97.59,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":89.53,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":98.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":94.01,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":86.84,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":89.53,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":94.01,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":91.32,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":89.53,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":89.53,"methodology":"fee schedule"}]}]},{"description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens ","code_information":[{"code":"V2106","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":53.21,"maximum":60.35,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":54.86,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":58.70,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":58.15,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":55.96,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":55.96,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":60.35,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":58.70,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":60.35,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":58.70,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":59.80,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":54.86,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":60.35,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":57.60,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":53.21,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":54.86,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":57.60,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":55.96,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":54.86,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":54.86,"methodology":"fee schedule"}]}]},{"description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens ","code_information":[{"code":"V2310","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":129.81,"maximum":147.20,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":133.82,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":143.19,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":141.85,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":136.50,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":136.50,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":147.20,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":143.19,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":147.20,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":143.19,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":145.86,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":133.82,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":147.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":140.51,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":129.81,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":133.82,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":140.51,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":136.50,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":133.82,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":133.82,"methodology":"fee schedule"}]}]},{"description":"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC ","code_information":[{"code":"538","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":20803.72,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":6182.63,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":6244.46,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6739.07,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6553.59,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":5863.30,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":8168.57,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":5863.30,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6244.46,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6244.46,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":8631.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":20803.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":8631.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":5863.30,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6800.89,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":10715.80,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":17116.53,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6553.59,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6739.07,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":6182.63,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6739.07,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6126.99,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5997.15,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":6553.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7728.29,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":6182.63,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":6182.63,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":6182.63,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5705.74,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6893.63,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6182.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":5910.60,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6182.63,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":6182.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6058.98,"methodology":"fee schedule"}]}]},{"description":"Standard hemi (low seat) wheelchair ","code_information":[{"code":"K0002","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":49.63,"maximum":56.29,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":51.17,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":54.75,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":54.24,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":52.19,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":52.19,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":56.29,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":54.75,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":56.29,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":54.75,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":55.78,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":51.17,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":56.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":53.73,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":49.63,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":51.17,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":53.73,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":52.19,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":51.17,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":51.17,"methodology":"fee schedule"}]}]},{"description":"Stoma cap ","code_information":[{"code":"A5055","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1.90,"maximum":2.16,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1.96,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2.10,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2.00,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2.00,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2.16,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2.10,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2.16,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2.10,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2.14,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1.96,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2.16,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2.06,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1.90,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1.96,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2.06,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2.00,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1.96,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1.96,"methodology":"fee schedule"}]}]},{"description":"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ","code_information":[{"code":"705024","type":"CDM"},{"code":"84377","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":4.99,"maximum":6.54,"gross_charge":68.39,"discounted_cash":68.39,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5.50,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":5.89,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":5.83,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5.61,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5.61,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6.05,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":5.89,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":6.05,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":5.89,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6.05,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4.99,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5.50,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":6.54,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":5.78,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5.61,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5.50,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5.50,"methodology":"fee schedule"}]}]},{"description":"Supplies for maintenance of insulin infusion catheter, per week ","code_information":[{"code":"A4224","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":23.73,"maximum":26.91,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":24.46,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":26.17,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":25.93,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":24.95,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":24.95,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":26.91,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":26.17,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":26.91,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":26.17,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":26.66,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":24.46,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":26.91,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":25.68,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":23.73,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":24.46,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":25.68,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":24.95,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":24.46,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":24.46,"methodology":"fee schedule"}]}]},{"description":"Surgical dressing holder, reusable, each ","code_information":[{"code":"A4463","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":17.62,"maximum":19.98,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":18.16,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19.43,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":19.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":18.52,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":18.52,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19.98,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19.43,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":19.98,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.43,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":19.79,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":18.16,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":19.98,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19.07,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":17.62,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.16,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19.07,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":18.52,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18.16,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18.16,"methodology":"fee schedule"}]}]},{"description":"Tenofovir, by liquid chromatography with tandem mass spectrometry (LC-MS/MS), urine, quantitative ","code_information":[{"code":"0025U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":114.43,"maximum":136.17,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":114.43,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":122.44,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":121.30,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":116.72,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":116.72,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":125.87,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":122.44,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":125.87,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":122.44,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":124.73,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":114.43,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":125.87,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":120.15,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":114.43,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":136.17,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":120.15,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":116.72,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":114.43,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":114.43,"methodology":"fee schedule"}]}]},{"description":"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility ","code_information":[{"code":"97110","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","minimum":24.32,"maximum":26.75,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":24.32,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":26.02,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":25.78,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":24.81,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":24.81,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":26.75,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":26.02,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":26.75,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":26.02,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":26.51,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":24.32,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":26.75,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":25.53,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":24.32,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":25.53,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":24.81,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":24.32,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":24.32,"methodology":"fee schedule"}]}]},{"description":"Thiopurine S-methyltransferase (TPMT) ","code_information":[{"code":"84433","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":20.10,"maximum":26.38,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":22.17,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":23.72,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":23.50,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":22.61,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":22.61,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":24.39,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":23.72,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":24.39,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":23.72,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":24.17,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":22.17,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":24.39,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":23.28,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":20.10,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":22.17,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":26.38,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":23.28,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":22.61,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":22.17,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":22.17,"methodology":"fee schedule"}]}]},{"description":"Thrombin time; titer ","code_information":[{"code":"85675","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":6.21,"maximum":8.15,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":6.85,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":7.33,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7.26,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6.99,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6.99,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7.54,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":7.33,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":7.54,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7.33,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7.47,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":6.85,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7.54,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":6.21,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":6.85,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":8.15,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":7.19,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6.99,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6.85,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6.85,"methodology":"fee schedule"}]}]},{"description":"Thyroglobulin antibody ","code_information":[{"code":"686366","type":"CDM"},{"code":"86800","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":14.42,"maximum":18.93,"gross_charge":52.61,"discounted_cash":52.61,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15.91,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":17.02,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16.86,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":16.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":16.23,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":17.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":17.02,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":17.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":17.02,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":17.34,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":15.91,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":17.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":16.71,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":14.42,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":15.91,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":18.93,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":16.71,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":16.23,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15.91,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15.91,"methodology":"fee schedule"}]}]},{"description":"Thyroxine; total ","code_information":[{"code":"684734","type":"CDM"},{"code":"84436","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":6.23,"maximum":8.18,"gross_charge":410.19,"discounted_cash":410.19,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":6.87,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":7.35,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7.28,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":7.01,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":7.01,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7.56,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":7.35,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":7.56,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7.35,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7.49,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":6.87,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7.56,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":6.23,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":6.87,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":8.18,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":7.21,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":7.01,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6.87,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6.87,"methodology":"fee schedule"}]}]},{"description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine ","code_information":[{"code":"L0482","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1742.03,"maximum":1975.50,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1795.91,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1921.62,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1903.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1831.83,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1831.83,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1975.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1921.62,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1975.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1921.62,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1957.54,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1795.91,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1975.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1885.71,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1742.03,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1795.91,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1885.71,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1831.83,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1795.91,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1795.91,"methodology":"fee schedule"}]}]},{"description":"Prosthetic shrinker, above knee, each ","code_information":[{"code":"L8460","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":82.96,"maximum":94.08,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":85.53,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":91.52,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":90.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":87.24,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":87.24,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":94.08,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":91.52,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":94.08,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":91.52,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":93.23,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":85.53,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":94.08,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":89.81,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":82.96,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":85.53,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":89.81,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":87.24,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":85.53,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":85.53,"methodology":"fee schedule"}]}]},{"description":"Protein, total, except by refractometry; serum, plasma or whole blood ","code_information":[{"code":"684750","type":"CDM"},{"code":"84155","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3.33,"maximum":4.37,"gross_charge":545.71,"discounted_cash":545.71,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3.67,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3.93,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3.74,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3.74,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.04,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3.93,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.04,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3.93,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3.67,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.04,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3.85,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3.33,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3.67,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":4.37,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3.85,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3.74,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3.67,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3.67,"methodology":"fee schedule"}]}]},{"description":"Radiation treatment deliv ","code_information":[{"code":"4007","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":212.37,"maximum":233.61,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":212.37,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":227.24,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":225.11,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":216.62,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":216.62,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":233.61,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":227.24,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":233.61,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":227.24,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":231.49,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":212.37,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":233.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":222.99,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":212.37,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":222.99,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":216.62,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":212.37,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":212.37,"methodology":"fee schedule"}]}]},{"description":"Rare constitutional and other heritable disorders, whole genome and mitochondrial DNA sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (FFPE) tissue, saliva, buccal swabs or cell ","code_information":[{"code":"0265U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":5475.80,"maximum":6516.20,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5475.80,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":5859.11,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":5804.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5585.32,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5585.32,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6023.38,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":5859.11,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":6023.38,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":5859.11,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":5968.62,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5475.80,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6023.38,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5749.59,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5475.80,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":6516.20,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":5749.59,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5585.32,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5475.80,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5475.80,"methodology":"fee schedule"}]}]},{"description":"Red blood cell antigen typing, DNA, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes ","code_information":[{"code":"0282U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":720.00,"maximum":856.80,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":720.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":770.40,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":763.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":734.40,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":734.40,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":792.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":770.40,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":792.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":770.40,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":784.80,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":720.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":792.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":756.00,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":720.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":856.80,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":756.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":734.40,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":720.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":720.00,"methodology":"fee schedule"}]}]},{"description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least one interactive communication with the pa ","code_information":[{"code":"98980","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":49.50,"maximum":54.45,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":49.50,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":52.97,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":52.47,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":50.49,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":50.49,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":54.45,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":52.97,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":54.45,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":52.97,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":53.96,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":49.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":54.45,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":51.98,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":49.50,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":51.98,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":50.49,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":49.50,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":49.50,"methodology":"fee schedule"}]}]},{"description":"Replace proximal and distal upright for kafo ","code_information":[{"code":"L4070","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":323.55,"maximum":366.92,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":333.56,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":356.91,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":353.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":340.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":340.23,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":366.92,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":356.91,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":366.92,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":356.91,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":363.58,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":333.56,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":366.92,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":350.24,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":323.55,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":333.56,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":350.24,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":340.23,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":333.56,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":333.56,"methodology":"fee schedule"}]}]},{"description":"TPMT (thiopurine S-methyltransferase), NUDT15 (nudix hydroxylase 15) (eg, thiopurine metabolism), gene analysis, common variants (ie, TPMT *2, *3A, *3B, *3C, *4, *5, *6, *8, *12; NUDT15 *3, *4, *5) ","code_information":[{"code":"0034U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":466.17,"maximum":554.74,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":466.17,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":498.80,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":494.14,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":475.49,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":475.49,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":512.79,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":498.80,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":512.79,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":498.80,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":508.13,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":466.17,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":512.79,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":489.48,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":466.17,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":554.74,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":489.48,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":475.49,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":466.17,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":466.17,"methodology":"fee schedule"}]}]},{"description":"Transcutaneous measurement of five biomarkers, using spatial frequency domain imaging (SFDI) and multi-spectral analysis ","code_information":[{"code":"0061U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":25.10,"maximum":29.87,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":25.10,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":26.86,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":26.61,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":25.60,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":25.60,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":27.61,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":26.86,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":27.61,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":26.86,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":27.36,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":25.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":27.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":26.36,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":25.10,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":29.87,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":26.36,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":25.60,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":25.10,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":25.10,"methodology":"fee schedule"}]}]},{"description":"Transplantation medicine (kidney allograft rejection), microarray gene expression profiling of 1494 genes, utilizing transplant biopsy tissue, algorithm reported as a probability score for rejection ","code_information":[{"code":"0088U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3159.42,"maximum":3759.71,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3159.42,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3380.58,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3348.99,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3222.61,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3222.61,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3475.36,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3380.58,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3475.36,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3380.58,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3443.77,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3159.42,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3475.36,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3317.39,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3159.42,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":3759.71,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3317.39,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3222.61,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3159.42,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3159.42,"methodology":"fee schedule"}]}]},{"description":"TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC ","code_information":[{"code":"085","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":57757.79,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":19808.04,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":20006.12,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":21590.76,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":20996.52,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":9132.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":12723.47,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":9132.74,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":20006.12,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":20006.12,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":13444.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":32404.14,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":13444.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":9132.74,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":21788.84,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":36159.23,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":57757.79,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":20996.52,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":21590.76,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":19808.04,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":21590.76,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":19629.77,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19213.80,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":20996.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":24760.05,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":19808.04,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":19808.04,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":19808.04,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":19253.35,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":22085.96,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19808.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":18936.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":19808.04,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":19808.04,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":19411.88,"methodology":"fee schedule"}]}]},{"description":"Upper extremity addition, excursion amplifier, pulley type ","code_information":[{"code":"L6641","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":182.39,"maximum":206.83,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":188.03,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":201.19,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":199.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":191.79,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":191.79,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":206.83,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":201.19,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":206.83,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":201.19,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":204.95,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":188.03,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":206.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":197.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":182.39,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":188.03,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":197.43,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":191.79,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":188.03,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":188.03,"methodology":"fee schedule"}]}]},{"description":"Upper facial prosthesis, provided by a non-physician ","code_information":[{"code":"L8043","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":4215.38,"maximum":4780.33,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4345.75,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4649.95,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4606.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4432.66,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4432.66,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4780.33,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4649.95,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4780.33,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4649.95,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4736.87,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4345.75,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4780.33,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4563.04,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4215.38,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4345.75,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4563.04,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4432.66,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4345.75,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4345.75,"methodology":"fee schedule"}]}]},{"description":"Urine pregnancy test, by visual color comparison methods ","code_information":[{"code":"684592","type":"CDM"},{"code":"81025","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":7.81,"maximum":10.25,"gross_charge":827.64,"discounted_cash":827.64,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8.61,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":9.21,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":9.13,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8.78,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8.78,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":9.47,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":9.21,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":9.47,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":9.21,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":9.38,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":8.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":9.47,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9.04,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":7.81,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8.61,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":10.25,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9.04,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8.78,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8.61,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8.61,"methodology":"fee schedule"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC ","code_information":[{"code":"737","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":72577.44,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":17521.19,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17696.40,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19098.10,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":18572.46,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":20455.14,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":28497.49,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":20455.14,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17696.40,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17696.40,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":30111.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":72577.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":30111.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":20455.14,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19273.31,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":31888.87,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":50936.67,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":18572.46,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19098.10,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":17521.19,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":19098.10,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":17363.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":16995.55,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":18572.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":21901.49,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":17521.19,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":17521.19,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":17521.19,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16979.56,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19536.13,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":17521.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":16750.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17521.19,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":17521.19,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":17170.77,"methodology":"fee schedule"}]}]},{"description":"VIRAL MENINGITIS WITHOUT CC/MCC ","code_information":[{"code":"076","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":45201.41,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":8279.77,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8362.57,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":9024.95,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8776.56,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":12739.51,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":17748.31,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":12739.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8362.57,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8362.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":18753.75,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":45201.41,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":18753.75,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":12739.51,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":9107.75,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":14631.89,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":23371.78,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8776.56,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":9024.95,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":8279.77,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":9024.95,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8205.25,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8031.38,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":8776.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10349.71,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":8279.77,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":8279.77,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":8279.77,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7790.90,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9231.94,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8279.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":7915.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8279.77,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":8279.77,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8114.17,"methodology":"fee schedule"}]}]},{"description":"Wheel attachment, rigid pick-up walker, per pair ","code_information":[{"code":"E0155","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":23.28,"maximum":26.40,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":24.00,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":25.68,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":25.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":24.48,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":24.48,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":26.40,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":25.68,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":26.40,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":25.68,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":26.16,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":24.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":26.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":25.20,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":23.28,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":24.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":25.20,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":24.48,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":24.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":24.00,"methodology":"fee schedule"}]}]},{"description":"Wheelchair, pediatric size, rigid, adjustable, with seating system ","code_information":[{"code":"E1235","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":245.85,"maximum":278.80,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":253.45,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":271.19,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":268.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":258.52,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":258.52,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":278.80,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":271.19,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":278.80,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":271.19,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":276.26,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":253.45,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":278.80,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":266.12,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":245.85,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":253.45,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":266.12,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":258.52,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":253.45,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":253.45,"methodology":"fee schedule"}]}]},{"description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad ","code_information":[{"code":"L6050","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":2159.76,"maximum":2449.22,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2226.56,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2382.42,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2360.15,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2271.09,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2271.09,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2449.22,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2382.42,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2449.22,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2382.42,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2426.95,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2226.56,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2449.22,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2337.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":2159.76,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2226.56,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2337.89,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2271.09,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2226.56,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2226.56,"methodology":"fee schedule"}]}]},{"description":" Specialty Services Observation Hours  ","code_information":[{"code":"762","type":"RC"}],"standard_charges":[{"setting":"outpatient","minimum":550.00,"maximum":18349.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges not to exceed $3511.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":18349.00,"methodology":"case rate"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4275.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":18349.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":19.30,"standard_charge_algorithm":"Reimbursement will be 19.3% of billable gross charges not to exceed $14188.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":5500.00,"methodology":"case rate"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":5500.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":8410.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":10639.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":8410.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4000.00,"methodology":"case rate"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4000.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":10848.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":16748.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":10848.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":8410.00,"methodology":"case rate"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_dollar":909.00,"methodology":"per diem"},{"payer_name":"Beacon Health Options","plan_name":"MCR","standard_charge_dollar":828.00,"methodology":"per diem"},{"payer_name":"Beacon Health Strategies","plan_name":"MCD","standard_charge_dollar":1018.00,"methodology":"per diem"},{"payer_name":"Beacon Health Strategies","plan_name":"MCR","standard_charge_dollar":1018.00,"methodology":"per diem"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":19.20,"standard_charge_algorithm":"Reimbursement will be 19.2% of billable gross charges not to exceed $23730.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":30.60,"standard_charge_algorithm":"Reimbursement will be 30.6% of billable gross charges not to exceed $30849.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":550.00,"methodology":"case rate"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":5250.00,"methodology":"case rate"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":5450.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges not to exceed $4180.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4500.00,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3800.00,"methodology":"case rate"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3800.00,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":4000.00,"methodology":"case rate"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3500.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges not to exceed $4180.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges not to exceed $4180.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges not to exceed $4180.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3875.00,"methodology":"case rate"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":7163.00,"methodology":"case rate"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"case rate"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4000.00,"methodology":"case rate"}]}]},{"description":"Acylcarnitines; qualitative, each specimen ","code_information":[{"code":"82016","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":14.95,"maximum":19.62,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":16.49,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":17.64,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":17.48,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":16.82,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":16.82,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":18.14,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":17.64,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":18.14,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":17.64,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":17.97,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":16.49,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":18.14,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":17.31,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":14.95,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":16.49,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":19.62,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":17.31,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":16.82,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":16.49,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":16.49,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section ","code_information":[{"code":"L2820","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":92.67,"maximum":105.09,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":95.54,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":102.23,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":101.27,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":97.45,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":97.45,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":105.09,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":102.23,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":105.09,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":102.23,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":104.14,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":95.54,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":105.09,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":100.32,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":92.67,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":95.54,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":100.32,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":97.45,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":95.54,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":95.54,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage ","code_information":[{"code":"L5698","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":149.24,"maximum":169.25,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":153.86,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":164.63,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":163.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":156.94,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":156.94,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":169.25,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":164.63,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":169.25,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":164.63,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":167.71,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":153.86,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":169.25,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":161.55,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":149.24,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":153.86,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":161.55,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":156.94,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":153.86,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":153.86,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism ","code_information":[{"code":"L5673","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":808.44,"maximum":916.78,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":833.44,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":891.78,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":883.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":850.11,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":850.11,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":916.78,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":891.78,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":916.78,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":891.78,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":908.45,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":833.44,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":916.78,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":875.11,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":808.44,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":833.44,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":875.11,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":850.11,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":833.44,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":833.44,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables ","code_information":[{"code":"L2628","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":2153.16,"maximum":2441.73,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2219.75,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2375.13,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2352.93,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2264.14,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2264.14,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2441.73,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2375.13,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2441.73,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2375.13,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2419.53,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2219.75,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2441.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2330.74,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":2153.16,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2219.75,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2330.74,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2264.14,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2219.75,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2219.75,"methodology":"fee schedule"}]}]},{"description":"Addition to lower extremity, test socket, symes ","code_information":[{"code":"L5618","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":340.32,"maximum":385.94,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":350.85,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":375.41,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":371.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":357.87,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":357.87,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":385.94,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":375.41,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":385.94,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":375.41,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":382.43,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":350.85,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":385.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":368.39,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":340.32,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":350.85,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":368.39,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":357.87,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":350.85,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":350.85,"methodology":"fee schedule"}]}]},{"description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control ","code_information":[{"code":"L5728","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":2705.37,"maximum":3067.94,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2789.04,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2984.27,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2956.38,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2844.82,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2844.82,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3067.94,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2984.27,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3067.94,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2984.27,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3040.05,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2789.04,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3067.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2928.49,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":2705.37,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2789.04,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2928.49,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2844.82,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2789.04,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2789.04,"methodology":"fee schedule"}]}]},{"description":"Adrenal cortical tumor, biochemical assay of 25 steroid markers, utilizing 24-hour urine specimen and clinical parameters, prognostic algorithm reported as a clinical risk and integrated clinical ster ","code_information":[{"code":"0015M","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":1305.37,"maximum":1553.39,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1305.37,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1396.75,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1383.69,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1331.48,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1331.48,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1435.91,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1396.75,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1435.91,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1396.75,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1422.85,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1305.37,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1435.91,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1370.64,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1305.37,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":1553.39,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1370.64,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1331.48,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1305.37,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1305.37,"methodology":"fee schedule"}]}]},{"description":"Albumin; ischemia modified ","code_information":[{"code":"82045","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":30.76,"maximum":40.39,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":33.94,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":36.32,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":35.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":34.62,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":34.62,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":37.33,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":36.32,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":37.33,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":36.32,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":36.99,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":33.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":37.33,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":35.64,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":30.76,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":33.94,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":40.39,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":35.64,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":34.62,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":33.94,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":33.94,"methodology":"fee schedule"}]}]},{"description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability ","code_information":[{"code":"L5984","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":647.69,"maximum":734.49,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":667.72,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":714.46,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":707.78,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":681.07,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":681.07,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":734.49,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":714.46,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":734.49,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":714.46,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":727.81,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":667.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":734.49,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":701.11,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":647.69,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":667.72,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":701.11,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":681.07,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":667.72,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":667.72,"methodology":"fee schedule"}]}]},{"description":"Amines, vaginal fluid, qualitative ","code_information":[{"code":"82120","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":5.43,"maximum":7.13,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5.99,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6.41,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6.11,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6.11,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6.59,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6.41,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":6.59,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6.41,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6.53,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5.99,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6.59,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6.29,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":5.43,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5.99,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7.13,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6.29,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6.11,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5.99,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5.99,"methodology":"fee schedule"}]}]},{"description":"AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC ","code_information":[{"code":"240","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":87166.52,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":25329.48,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":25582.77,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":27609.13,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":26849.25,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":24566.91,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":34225.89,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":24566.91,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":25582.77,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":25582.77,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":36164.78,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":87166.52,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":36164.78,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":24566.91,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":27862.43,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":46469.70,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":74226.88,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":26849.25,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":27609.13,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":25329.48,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":27609.13,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":25101.51,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":24569.60,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":26849.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":31661.85,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":25329.48,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":25329.48,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":25329.48,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":24743.26,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":28242.37,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":25329.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":24214.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":25329.48,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":25329.48,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":24822.89,"methodology":"fee schedule"}]}]},{"description":"Ancillary Outpatient Serv ","code_information":[{"code":"5881","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":7958.66,"maximum":8754.52,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7958.66,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":8515.76,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8436.18,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8117.83,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8117.83,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8754.52,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8515.76,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":8754.52,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":8515.76,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8674.94,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":7958.66,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8754.52,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8356.59,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7958.66,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8356.59,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8117.83,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":7958.66,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7958.66,"methodology":"fee schedule"}]}]},{"description":"Aniseikonic lens, single vision ","code_information":[{"code":"V2118","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":83.37,"maximum":94.55,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":85.95,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":91.97,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":91.11,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":87.67,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":87.67,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":94.55,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":91.97,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":94.55,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":91.97,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":93.69,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":85.95,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":94.55,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":90.25,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":83.37,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":85.95,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":90.25,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":87.67,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":85.95,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":85.95,"methodology":"fee schedule"}]}]},{"description":"Anterior chamber intraocular lens ","code_information":[{"code":"V2630","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":135.33,"maximum":153.47,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":139.52,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":149.29,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":147.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":142.31,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":142.31,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":153.47,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":149.29,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":153.47,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":149.29,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":152.08,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":139.52,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":153.47,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":146.50,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":135.33,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":139.52,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":146.50,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":142.31,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":139.52,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":139.52,"methodology":"fee schedule"}]}]},{"description":"Antibody; adenovirus ","code_information":[{"code":"86603","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":11.67,"maximum":15.32,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12.87,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13.77,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13.64,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":13.13,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":13.13,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":14.16,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13.77,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":14.16,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13.77,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":14.03,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":12.87,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14.16,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":13.51,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":11.67,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12.87,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":15.32,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":13.51,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":13.13,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12.87,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12.87,"methodology":"fee schedule"}]}]},{"description":"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ","code_information":[{"code":"685650","type":"CDM"},{"code":"86689","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":17.54,"maximum":23.03,"gross_charge":820.87,"discounted_cash":820.87,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":19.35,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":20.70,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":20.51,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19.74,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19.74,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":21.29,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":20.70,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":21.29,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":20.70,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":21.09,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":19.35,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":21.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":20.32,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":17.54,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":19.35,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":23.03,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":20.32,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19.74,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":19.35,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":19.35,"methodology":"fee schedule"}]}]},{"description":"Antibody; protozoa, not elsewhere specified ","code_information":[{"code":"86753","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":11.23,"maximum":14.74,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12.39,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13.26,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13.13,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":12.64,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":12.64,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":13.63,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13.26,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":13.63,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13.26,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13.51,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":12.39,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":13.63,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":13.01,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":11.23,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12.39,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":14.74,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":13.01,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":12.64,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12.39,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12.39,"methodology":"fee schedule"}]}]},{"description":"Antibody; West Nile virus ","code_information":[{"code":"86789","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":13.05,"maximum":17.12,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14.39,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":15.40,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":15.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14.68,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14.68,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15.83,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":15.40,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":15.83,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":15.40,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":15.69,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":14.39,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":15.11,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":13.05,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":14.39,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":17.12,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":15.11,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14.68,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14.39,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14.39,"methodology":"fee schedule"}]}]},{"description":"Argatroban dialysis (acco ","code_information":[{"code":"9021","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":4.20,"maximum":4.62,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4.20,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4.49,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4.28,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4.28,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.62,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4.49,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.62,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4.49,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.58,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.62,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4.41,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4.20,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4.41,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4.28,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4.20,"methodology":"fee schedule"}]}]},{"description":"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ","code_information":[{"code":"81175","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":676.50,"maximum":805.03,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":676.50,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":723.86,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":717.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":690.03,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":690.03,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":744.15,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":723.86,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":744.15,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":723.86,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":737.39,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":676.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":744.15,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":710.33,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":676.50,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":805.03,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":710.33,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":690.03,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":676.50,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":676.50,"methodology":"fee schedule"}]}]},{"description":"BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST ","code_information":[{"code":"518","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":105335.82,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":31070.55,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":34980.00,"methodology":"case rate"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":31381.26,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":34980.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_dollar":19452.00,"methodology":"case rate"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":33866.90,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":32934.78,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":74994.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":35719.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":68861.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":29687.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":41360.05,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":29687.72,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":31381.26,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":31381.26,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":43703.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":105335.82,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":43703.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":29687.72,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":34177.61,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":44158.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":58160.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":32934.78,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":33866.90,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":31070.55,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":33866.90,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":32468.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":30138.43,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":32934.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":38838.19,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":31070.55,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":31070.55,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":31070.55,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":30451.55,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":34643.66,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":31070.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":35793.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":29703.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":26748.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":31070.55,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":31070.55,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":30449.14,"methodology":"fee schedule"}]}]},{"description":"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ","code_information":[{"code":"81206","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":163.96,"maximum":195.11,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":163.96,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":175.44,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":173.80,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":167.24,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":167.24,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":180.36,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":175.44,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":180.36,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":175.44,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":178.72,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":163.96,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":180.36,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":172.16,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":163.96,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":195.11,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":172.16,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":167.24,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":163.96,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":163.96,"methodology":"fee schedule"}]}]},{"description":"Bifocal seg width over 28 mm ","code_information":[{"code":"V2219","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":50.62,"maximum":57.41,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":52.19,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":55.84,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":55.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":53.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":53.23,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":57.41,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":55.84,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":57.41,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":55.84,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":56.89,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":52.19,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":57.41,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":54.80,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":50.62,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":52.19,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":54.80,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":53.23,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":52.19,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":52.19,"methodology":"fee schedule"}]}]},{"description":"Blood typing, serologic; Rh (D) ","code_information":[{"code":"686577","type":"CDM"},{"code":"86901","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":2.99,"maximum":3.56,"gross_charge":326.70,"discounted_cash":326.70,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2.99,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3.20,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3.17,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3.05,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3.05,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3.29,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3.20,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3.29,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3.20,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3.26,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2.99,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3.14,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2.99,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":3.56,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3.14,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3.05,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2.99,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2.99,"methodology":"fee schedule"}]}]},{"description":"Brachytx, non-stranded,C- ","code_information":[{"code":"2643","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":80.33,"maximum":88.36,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":80.33,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":85.95,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":85.15,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":81.94,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":81.94,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":88.36,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":85.95,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":88.36,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":85.95,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":87.56,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":80.33,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":88.36,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":84.35,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":80.33,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":84.35,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":81.94,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":80.33,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":80.33,"methodology":"fee schedule"}]}]},{"description":"Buprenorphine xr over 100 ","code_information":[{"code":"9239","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":1943.06,"maximum":2137.36,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1943.06,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2079.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2059.64,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1981.92,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1981.92,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2137.36,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2079.07,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2137.36,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2079.07,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2117.93,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1943.06,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2137.36,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2040.21,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1943.06,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2040.21,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1981.92,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1943.06,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1943.06,"methodology":"fee schedule"}]}]},{"description":"Candida species panel (C. albicans, C. glabrata, C. parapsilosis, C. kruseii, C. tropicalis, and C. auris), amplified probe technique with qualitative report of the presence or absence of each species ","code_information":[{"code":"0068U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":129.27,"maximum":169.73,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":142.63,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":152.61,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":151.19,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":145.48,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":145.48,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":156.89,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":152.61,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":156.89,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":152.61,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":155.47,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":142.63,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":156.89,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":149.76,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":129.27,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":142.63,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":169.73,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":149.76,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":145.48,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":142.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":142.63,"methodology":"fee schedule"}]}]},{"description":"CARDIAC ARREST, UNEXPLAINED WITH CC ","code_information":[{"code":"297","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":59150.80,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":6463.79,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":6528.42,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":7045.53,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6851.61,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":16670.99,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":23225.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":16670.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6528.42,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6528.42,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":24541.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":59150.80,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":24541.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":16670.99,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7110.17,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":11240.82,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":17955.16,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6851.61,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7045.53,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":6463.79,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7045.53,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6405.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6269.87,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":6851.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8079.73,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":6463.79,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":6463.79,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":6463.79,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5985.29,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":7207.12,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6463.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":6179.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6463.79,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":6463.79,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6334.51,"methodology":"fee schedule"}]}]},{"description":"Cardiology (heart transplant), cell-free DNA, PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets), plasma ","code_information":[{"code":"0055U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3240.00,"maximum":3855.60,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3240.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3466.80,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3434.40,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3304.80,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3304.80,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3564.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3466.80,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3564.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3466.80,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3531.60,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3240.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3564.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3402.00,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3240.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":3855.60,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3402.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3304.80,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3240.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3240.00,"methodology":"fee schedule"}]}]},{"description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster ","code_information":[{"code":"Q4035","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":15.95,"maximum":18.08,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":16.44,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":17.59,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":17.43,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":16.77,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":16.77,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":18.08,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":17.59,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":18.08,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":17.59,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":17.92,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":16.44,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":18.08,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":17.26,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":15.95,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":16.44,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":17.26,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":16.77,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":16.44,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":16.44,"methodology":"fee schedule"}]}]},{"description":"Catheterization for collection of specimen, single patient, all places of service ","code_information":[{"code":"679913","type":"CDM"},{"code":"P9612","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":8.57,"maximum":10.51,"gross_charge":35.09,"discounted_cash":35.09,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8.83,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":9.45,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":9.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":9.01,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":9.01,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":9.71,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":9.45,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":9.71,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":9.45,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":9.62,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":8.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":9.71,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":8.57,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8.83,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":10.51,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9.27,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":9.01,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8.83,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8.83,"methodology":"fee schedule"}]}]},{"description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar) ","code_information":[{"code":"968822","type":"CDM"},{"code":"L0120","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":32.11,"maximum":36.41,"gross_charge":330.23,"discounted_cash":330.23,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":33.10,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":35.42,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":33.76,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":33.76,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":36.41,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":35.42,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":36.41,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":35.42,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":36.08,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":33.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":36.41,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":34.76,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":32.11,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":33.10,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":34.76,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":33.76,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":33.10,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":33.10,"methodology":"fee schedule"}]}]},{"description":"CESAREAN SECTION WITH STERILIZATION WITH CC ","code_information":[{"code":"784","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":37198.39,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":9699.23,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":17284.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":9796.22,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":17284.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_dollar":9612.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":10572.16,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10281.18,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":19127.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":12583.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":17563.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":18810.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":26583.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":18810.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":9796.22,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":9796.22,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":26853.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":37198.39,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":26853.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":18810.00,"methodology":"case rate"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":10669.15,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":16271.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":20605.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10281.18,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10572.16,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":9699.23,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":10572.16,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":9611.93,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9408.25,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":9650.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":10281.18,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12124.03,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":9699.23,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":9699.23,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":9699.23,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":13425.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":10814.64,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":9322.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":9699.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":9272.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":9699.23,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":9699.23,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":9505.24,"methodology":"fee schedule"}]}]},{"description":"CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC ","code_information":[{"code":"846","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":65091.26,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":22266.67,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":22489.34,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":24270.67,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":23602.67,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":4152.48,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":5785.11,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":4152.48,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":22489.34,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":22489.34,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":6112.84,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":14733.53,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":6112.84,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":4152.48,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":24493.34,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":40750.35,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":65091.26,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":23602.67,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":24270.67,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":22266.67,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":24270.67,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":22066.27,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":21598.67,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":23602.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":27833.34,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":22266.67,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":22266.67,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":22266.67,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":21697.94,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":24827.34,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":22266.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":21286.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":22266.67,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":22266.67,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":21821.34,"methodology":"fee schedule"}]}]},{"description":"Chloride; other source ","code_information":[{"code":"685086","type":"CDM"},{"code":"82438","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":4.53,"maximum":5.95,"gross_charge":89.78,"discounted_cash":89.78,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":5.35,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":5.30,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5.10,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5.10,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":5.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":5.35,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":5.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":5.35,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":5.45,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5.25,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4.53,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5.95,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":5.25,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5.10,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5.00,"methodology":"fee schedule"}]}]},{"description":"Clotting; factor VII (proconvertin, stable factor) ","code_information":[{"code":"685404","type":"CDM"},{"code":"85230","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":16.23,"maximum":21.30,"gross_charge":40.73,"discounted_cash":40.73,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17.90,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19.15,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":18.97,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":18.26,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":18.26,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19.69,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19.15,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":19.69,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.15,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":19.51,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":17.90,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":19.69,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":18.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.23,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":17.90,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":21.30,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18.79,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":18.26,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17.90,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":17.90,"methodology":"fee schedule"}]}]},{"description":"Cold agglutinin; screen ","code_information":[{"code":"684160","type":"CDM"},{"code":"86156","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":7.31,"maximum":9.60,"gross_charge":583.22,"discounted_cash":583.22,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8.07,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":8.63,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8.23,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8.88,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8.63,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":8.88,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":8.63,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8.80,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":8.07,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8.88,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8.47,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":7.31,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8.07,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":9.60,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8.47,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8.23,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8.07,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8.07,"methodology":"fee schedule"}]}]},{"description":"CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION ","code_information":[{"code":"317","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":212748.91,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":53308.41,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":55923.00,"methodology":"case rate"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":53841.49,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":55923.00,"methodology":"case rate"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":58106.17,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":56506.91,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":59960.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":83535.74,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":59960.90,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":53841.49,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":53841.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":88268.03,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":212748.91,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":88268.03,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":59960.90,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":58639.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":98716.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":157681.14,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":56506.91,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":58106.17,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":53308.41,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":58106.17,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":52828.63,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":51709.16,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":56506.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":66635.51,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":53308.41,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":53308.41,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":53308.41,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":52562.44,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":59438.88,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":53308.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":71240.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":50962.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":53239.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":53308.41,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":53308.41,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":52242.24,"methodology":"fee schedule"}]}]},{"description":"Continuous passive motion exercise device for use on knee only ","code_information":[{"code":"E0935","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":30.11,"maximum":34.14,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":31.04,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":33.21,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":32.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":31.66,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":31.66,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":34.14,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":33.21,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":34.14,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":33.21,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":33.83,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":31.04,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":34.14,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":32.59,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":30.11,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":31.04,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":32.59,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":31.66,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":31.04,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":31.04,"methodology":"fee schedule"}]}]},{"description":"Coupling gel or paste, for use with ultrasound device, per oz ","code_information":[{"code":"A4559","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":0.13,"maximum":0.14,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":0.13,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":0.14,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":0.14,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":0.13,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":0.13,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":0.14,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":0.14,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":0.14,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":0.14,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":0.14,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":0.13,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":0.14,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":0.14,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":0.13,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":0.13,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":0.14,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":0.13,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":0.13,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":0.13,"methodology":"fee schedule"}]}]},{"description":"Cryoprecipitatereducedpla ","code_information":[{"code":"9523","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":69.15,"maximum":76.07,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":69.15,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":73.99,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":73.30,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":70.53,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":70.53,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":76.07,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":73.99,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":76.07,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":73.99,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":75.37,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":69.15,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":76.07,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":72.61,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":69.15,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":72.61,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":70.53,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":69.15,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":69.15,"methodology":"fee schedule"}]}]},{"description":"Culture, fungi, definitive identification, each organism; mold ","code_information":[{"code":"87107","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":9.35,"maximum":12.28,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":10.32,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":11.04,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10.94,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":10.53,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":10.53,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":11.35,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":11.04,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":11.35,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":11.04,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":11.25,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":10.32,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":11.35,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":10.84,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":9.35,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10.32,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":12.28,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":10.84,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":10.53,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":10.32,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":10.32,"methodology":"fee schedule"}]}]},{"description":"Cyanocobalamin (Vitamin B-12); ","code_information":[{"code":"684790","type":"CDM"},{"code":"82607","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":13.67,"maximum":17.95,"gross_charge":1087.79,"discounted_cash":1087.79,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15.08,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16.14,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":15.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15.38,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15.38,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":16.59,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16.14,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":16.59,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16.14,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16.44,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":15.08,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":16.59,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":15.83,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":13.67,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":15.08,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":17.95,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":15.83,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15.38,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15.08,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15.08,"methodology":"fee schedule"}]}]},{"description":"Cytog Const Alys Interrog Gen Reg F/Copy Number ","code_information":[{"code":"0209U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":787.15,"maximum":936.71,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":787.15,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":842.25,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":834.38,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":802.89,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":802.89,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":865.87,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":842.25,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":865.87,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":842.25,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":857.99,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":787.15,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":865.87,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":826.51,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":787.15,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":936.71,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":826.51,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":802.89,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":787.15,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":787.15,"methodology":"fee schedule"}]}]},{"description":"Dexrazoxane HCl injection ","code_information":[{"code":"726","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":87.49,"maximum":96.24,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":87.49,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":93.62,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":92.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":89.24,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":89.24,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":96.24,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":93.62,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":96.24,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":93.62,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":95.37,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":87.49,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":96.24,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":91.87,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":87.49,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":91.87,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":89.24,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":87.49,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":87.49,"methodology":"fee schedule"}]}]},{"description":"DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC ","code_information":[{"code":"439","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":33353.36,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":7795.22,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7873.17,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":8496.79,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8262.94,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":20444.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":28317.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":20444.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":7873.17,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":7873.17,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":28341.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":33353.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":28341.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":20444.00,"methodology":"case rate"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8574.74,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":13727.07,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":21926.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8262.94,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":8496.79,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":7795.22,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8496.79,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7725.07,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7561.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":8262.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":9744.03,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":7795.22,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":7795.22,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":7795.22,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7309.12,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8691.67,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":7795.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":7452.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":7795.22,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":7795.22,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7639.32,"methodology":"fee schedule"}]}]},{"description":"Driver for use with pneumatic ventricular assist device, replacement only ","code_information":[{"code":"Q0480","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":96999.90,"maximum":109999.89,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":99999.90,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":106999.89,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":105999.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":101999.90,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":101999.90,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":109999.89,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":106999.89,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":109999.89,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":106999.89,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":108999.89,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":99999.90,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":109999.89,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":104999.90,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":96999.90,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":99999.90,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":104999.90,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":101999.90,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":99999.90,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":99999.90,"methodology":"fee schedule"}]}]},{"description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectroni ","code_information":[{"code":"L6945","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":12188.63,"maximum":13822.16,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12565.60,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13445.19,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13319.54,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":12816.91,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":12816.91,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":13822.16,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13445.19,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":13822.16,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13445.19,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13696.50,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":12565.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":13822.16,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":13193.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":12188.63,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12565.60,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":13193.88,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":12816.91,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12565.60,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12565.60,"methodology":"fee schedule"}]}]},{"description":"Electrical stimulation to aid bone healing; noninvasive (nonoperative) ","code_information":[{"code":"20974","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":80.71,"maximum":2702.00,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":83.21,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":89.03,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":88.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":9.50,"standard_charge_algorithm":"Reimbursement will be 9.5% of billable gross charges not to exceed $9704.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":13.60,"standard_charge_algorithm":"Reimbursement will be 13.6% of billable gross charges not to exceed $11467.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":9.50,"standard_charge_algorithm":"Reimbursement will be 9.5% of billable gross charges not to exceed $9704.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":84.87,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":84.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":13.80,"standard_charge_algorithm":"Reimbursement will be 13.8% of billable gross charges not to exceed $11616.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges not to exceed $23153.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":13.80,"standard_charge_algorithm":"Reimbursement will be 13.8% of billable gross charges not to exceed $11616.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":9.50,"standard_charge_algorithm":"Reimbursement will be 9.5% of billable gross charges not to exceed $9704.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":91.53,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":89.03,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":91.53,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":89.03,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":90.70,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":83.21,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":91.53,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":87.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":80.71,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":2702.00,"methodology":"case rate","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":1950.00,"methodology":"case rate"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":83.21,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":87.37,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":84.87,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":83.21,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":83.21,"methodology":"fee schedule"}]}]},{"description":"Endo, single, pulmonary ","code_information":[{"code":"2042","type":"APC"}],"standard_charges":[{"setting":"outpatient","payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":38.20,"standard_charge_algorithm":"Reimbursement will be 38.2% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_percentage":40.87,"standard_charge_algorithm":"Reimbursement will be 40.87% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_percentage":40.49,"standard_charge_algorithm":"Reimbursement will be 40.49% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_percentage":38.96,"standard_charge_algorithm":"Reimbursement will be 38.96% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":38.96,"standard_charge_algorithm":"Reimbursement will be 38.96% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_percentage":42.02,"standard_charge_algorithm":"Reimbursement will be 42.02% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_percentage":40.87,"standard_charge_algorithm":"Reimbursement will be 40.87% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_percentage":42.02,"standard_charge_algorithm":"Reimbursement will be 42.02% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_percentage":40.87,"standard_charge_algorithm":"Reimbursement will be 40.87% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_percentage":41.64,"standard_charge_algorithm":"Reimbursement will be 41.64% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_percentage":38.20,"standard_charge_algorithm":"Reimbursement will be 38.2% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_percentage":42.02,"standard_charge_algorithm":"Reimbursement will be 42.02% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_percentage":40.11,"standard_charge_algorithm":"Reimbursement will be 40.11% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_percentage":38.20,"standard_charge_algorithm":"Reimbursement will be 38.2% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_percentage":40.11,"standard_charge_algorithm":"Reimbursement will be 40.11% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_percentage":38.96,"standard_charge_algorithm":"Reimbursement will be 38.96% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":38.20,"standard_charge_algorithm":"Reimbursement will be 38.2% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_percentage":38.20,"standard_charge_algorithm":"Reimbursement will be 38.2% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"}]}]},{"description":"Elosulfase alfa, injectio ","code_information":[{"code":"1480","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":293.92,"maximum":323.31,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":293.92,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":314.49,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":311.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":299.79,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":299.79,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":323.31,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":314.49,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":323.31,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":314.49,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":320.37,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":293.92,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":323.31,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":308.61,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":293.92,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":308.61,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":299.79,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":293.92,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":293.92,"methodology":"fee schedule"}]}]},{"description":"Epoetin alfa, non-esrd ","code_information":[{"code":"1686","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":7.53,"maximum":8.28,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7.53,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":8.05,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":7.68,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":7.68,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8.28,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8.05,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":8.28,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":8.05,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8.21,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":7.53,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8.28,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7.90,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7.53,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":7.90,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":7.68,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":7.53,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7.53,"methodology":"fee schedule"}]}]},{"description":"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ","code_information":[{"code":"81416","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":10876.42,"maximum":14280.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12000.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":12840.00,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":12720.00,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":12240.00,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":12240.00,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":13200.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":12840.00,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":13200.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":12840.00,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13080.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":12000.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":13200.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":12600.00,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":10876.42,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12000.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":14280.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":12600.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":12240.00,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12000.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12000.00,"methodology":"fee schedule"}]}]},{"description":"Fat or lipids, feces; qualitative ","code_information":[{"code":"684291","type":"CDM"},{"code":"82705","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":4.63,"maximum":6.07,"gross_charge":425.92,"discounted_cash":425.92,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5.10,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":5.46,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":5.41,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5.20,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5.20,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":5.61,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":5.46,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":5.61,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":5.46,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":5.56,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5.35,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4.63,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5.10,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":6.07,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":5.35,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5.20,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5.10,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5.10,"methodology":"fee schedule"}]}]},{"description":"Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ","code_information":[{"code":"685813","type":"CDM"},{"code":"83661","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":19.93,"maximum":26.17,"gross_charge":134.68,"discounted_cash":134.68,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":21.99,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":23.53,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":23.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":22.43,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":22.43,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":24.19,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":23.53,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":24.19,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":23.53,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":23.97,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":21.99,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":24.19,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":23.09,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":19.93,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":21.99,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":26.17,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":23.09,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":22.43,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":21.99,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":21.99,"methodology":"fee schedule"}]}]},{"description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each ","code_information":[{"code":"A7503","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":15.02,"maximum":17.03,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15.48,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16.56,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16.41,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15.79,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15.79,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":17.03,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16.56,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":17.03,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16.56,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16.87,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":15.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":17.03,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":16.25,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":15.02,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":15.48,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":16.25,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15.79,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15.48,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15.48,"methodology":"fee schedule"}]}]},{"description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ","code_information":[{"code":"A6209","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":9.89,"maximum":11.22,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":10.20,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":10.91,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10.81,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":10.40,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":10.40,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":11.22,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10.91,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":11.22,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10.91,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":11.12,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":10.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":11.22,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":10.71,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":9.89,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10.20,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":10.71,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":10.40,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":10.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":10.20,"methodology":"fee schedule"}]}]},{"description":"Foot, arch support, non-removable attached to shoe, longitudinal, each ","code_information":[{"code":"L3070","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":36.48,"maximum":41.37,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":37.61,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":40.24,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":39.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":38.36,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":38.36,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":41.37,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":40.24,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":41.37,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":40.24,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":40.99,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":37.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":41.37,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":39.49,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":36.48,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":37.61,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":39.49,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":38.36,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":37.61,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":37.61,"methodology":"fee schedule"}]}]},{"description":"Galactose-1-phosphate uridyl transferase; quantitative ","code_information":[{"code":"82775","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":19.10,"maximum":25.07,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":21.07,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":22.54,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":22.33,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":21.49,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":21.49,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":23.18,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":22.54,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":23.18,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":22.54,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":22.97,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":21.07,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":23.18,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":22.12,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":19.10,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":21.07,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":25.07,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":22.12,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":21.49,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":21.07,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":21.07,"methodology":"fee schedule"}]}]},{"description":"Gel-one ","code_information":[{"code":"1417","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":534.48,"maximum":587.93,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":534.48,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":571.90,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":566.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":545.17,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":545.17,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":587.93,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":571.90,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":587.93,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":571.90,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":582.59,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":534.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":587.93,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":561.21,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":534.48,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":561.21,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":545.17,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":534.48,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":534.48,"methodology":"fee schedule"}]}]},{"description":"Glutathione reductase, RBC ","code_information":[{"code":"82979","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":8.56,"maximum":11.23,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":9.44,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":10.10,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10.01,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":9.63,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":9.63,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":10.38,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10.10,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":10.38,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10.10,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":10.29,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":9.44,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":10.38,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9.91,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":8.56,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":9.44,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":11.23,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9.91,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":9.63,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":9.44,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":9.44,"methodology":"fee schedule"}]}]},{"description":"Gradient  compression arm sleeve, each ","code_information":[{"code":"A6578","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":72.94,"maximum":82.72,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":75.20,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":80.46,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":79.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":76.70,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":76.70,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":82.72,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":80.46,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":82.72,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":80.46,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":81.97,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":75.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":82.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":78.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":72.94,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":75.20,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":78.96,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":76.70,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":75.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":75.20,"methodology":"fee schedule"}]}]},{"description":"Gradient compression garment, neck/head, custom, each ","code_information":[{"code":"A6567","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":733.98,"maximum":832.35,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":756.68,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":809.65,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":802.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":771.81,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":771.81,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":832.35,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":809.65,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":832.35,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":809.65,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":824.78,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":756.68,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":832.35,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":794.51,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":733.98,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":756.68,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":794.51,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":771.81,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":756.68,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":756.68,"methodology":"fee schedule"}]}]},{"description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each ","code_information":[{"code":"A6545","type":"HCPCS"}],"standard_charges":[{"modifiers":"AW","modifiers_description":"Item furnished in conjunction with a surgical dressing","setting":"outpatient","minimum":112.75,"maximum":127.86,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":116.24,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":124.38,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":123.21,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":118.56,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":118.56,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":127.86,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":124.38,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":127.86,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":124.38,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":126.70,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":116.24,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":127.86,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":122.05,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":112.75,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":116.24,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":122.05,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":118.56,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":116.24,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":116.24,"methodology":"fee schedule"}]}]},{"description":"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC ","code_information":[{"code":"514","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":25989.60,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":9157.42,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":9249.00,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":9981.59,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":9706.87,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":4841.65,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":6745.25,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":4841.65,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":9249.00,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":9249.00,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":7127.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":17178.80,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":7127.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":4841.65,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":10073.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":16270.78,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":25989.60,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":9706.87,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":9981.59,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":9157.42,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":9981.59,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":9075.01,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8882.70,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":9706.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":11446.78,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":9157.42,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":9157.42,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":9157.42,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":8663.54,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":10210.53,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":9157.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":8754.50,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":9157.42,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":9157.42,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8974.27,"methodology":"fee schedule"}]}]},{"description":"Heel wedge, sach ","code_information":[{"code":"L3340","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":97.81,"maximum":110.92,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":100.84,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":107.90,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":106.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":102.86,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":102.86,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":110.92,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":107.90,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":110.92,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":107.90,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":109.92,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":100.84,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":110.92,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":105.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":97.81,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":100.84,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":105.88,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":102.86,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":100.84,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":100.84,"methodology":"fee schedule"}]}]},{"description":"Heparin assay ","code_information":[{"code":"85520","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":11.86,"maximum":15.58,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":13.09,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":14.01,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13.88,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":13.35,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":13.35,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":14.40,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":14.01,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":14.40,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":14.01,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":14.27,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":13.09,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":13.74,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":11.86,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":13.09,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":15.58,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":13.74,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":13.35,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":13.09,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":13.09,"methodology":"fee schedule"}]}]},{"description":"Heterophile antibodies; titer ","code_information":[{"code":"86309","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":5.87,"maximum":7.70,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":6.47,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6.92,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6.86,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6.60,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6.60,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7.12,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6.92,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":7.12,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6.92,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7.05,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":6.47,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":5.87,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":6.47,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7.70,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6.79,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6.60,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6.47,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6.47,"methodology":"fee schedule"}]}]},{"description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot ","code_information":[{"code":"L5270","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":5872.94,"maximum":6660.04,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":6054.58,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6478.40,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6417.85,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6175.67,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6175.67,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6660.04,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6478.40,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":6660.04,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6478.40,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6599.49,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":6054.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6660.04,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6357.31,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":5872.94,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":6054.58,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6357.31,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6175.67,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6054.58,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6054.58,"methodology":"fee schedule"}]}]},{"description":"HIV WITH MAJOR RELATED CONDITION WITH MCC ","code_information":[{"code":"974","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":76113.14,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":25961.87,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":26221.49,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":28298.44,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":27519.58,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":20039.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":27918.17,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":20039.31,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":26221.49,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":26221.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":29499.73,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":71102.02,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":29499.73,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":20039.31,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":28558.06,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":47650.59,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":76113.14,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":27519.58,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":28298.44,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":25961.87,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":28298.44,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":25728.21,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":25183.01,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":27519.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":32452.34,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":25961.87,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":25961.87,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":25961.87,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":25372.04,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":28947.49,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":25961.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":24819.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":25961.87,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":25961.87,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":25442.63,"methodology":"fee schedule"}]}]},{"description":"HLA typing; lymphocyte culture, mixed (MLC) ","code_information":[{"code":"86821","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":33.14,"maximum":43.51,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":36.56,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":39.12,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":38.75,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":37.29,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":37.29,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":40.22,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":39.12,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":40.22,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":39.12,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":39.85,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":36.56,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":40.22,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":38.39,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":33.14,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":36.56,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":43.51,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":38.39,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":37.29,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":36.56,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":36.56,"methodology":"fee schedule"}]}]},{"description":"Hydroxychloroquine ","code_information":[{"code":"80220","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":16.90,"maximum":22.18,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":19.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":20.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19.57,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.90,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":22.18,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19.57,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18.64,"methodology":"fee schedule"}]}]},{"description":"Idursulfase injection ","code_information":[{"code":"9045","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":537.92,"maximum":591.72,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":537.92,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":575.58,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":570.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":548.68,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":548.68,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":591.72,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":575.58,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":591.72,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":575.58,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":586.34,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":537.92,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":591.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":564.82,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":537.92,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":564.82,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":548.68,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":537.92,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":537.92,"methodology":"fee schedule"}]}]},{"description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment ","code_information":[{"code":"L5430","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":572.14,"maximum":648.81,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":589.83,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":631.12,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":625.22,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":601.63,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":601.63,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":648.81,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":631.12,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":648.81,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":631.12,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":642.91,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":589.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":648.81,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":619.32,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":572.14,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":589.83,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":619.32,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":601.63,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":589.83,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":589.83,"methodology":"fee schedule"}]}]},{"description":"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC ","code_information":[{"code":"759","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":26172.31,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":5912.58,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5971.71,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6444.72,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6267.34,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":7376.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":10276.54,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":7376.37,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5971.71,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5971.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":10858.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":26172.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":10858.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":7376.37,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6503.84,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":10211.52,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":16311.05,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6267.34,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6444.72,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":5912.58,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6444.72,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5859.37,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5735.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":6267.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7390.73,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":5912.58,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":5912.58,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":5912.58,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5437.23,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6592.53,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5912.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":5652.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5912.58,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":5912.58,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5794.33,"methodology":"fee schedule"}]}]},{"description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC ","code_information":[{"code":"87328","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":12.52,"maximum":16.45,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":13.82,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":14.79,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":14.65,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14.10,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14.10,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15.20,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":14.79,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":15.20,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":14.79,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":15.06,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":13.82,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14.51,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":12.52,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":13.82,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16.45,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":14.51,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14.10,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":13.82,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":13.82,"methodology":"fee schedule"}]}]},{"description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ","code_information":[{"code":"87806","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":29.70,"maximum":39.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":32.77,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":35.06,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":34.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":33.43,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":33.43,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":36.05,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":35.06,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":36.05,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":35.06,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":35.72,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":32.77,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":36.05,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":34.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":29.70,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":32.77,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":39.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":34.41,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":33.43,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":32.77,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":32.77,"methodology":"fee schedule"}]}]},{"description":"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ","code_information":[{"code":"87468","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":31.81,"maximum":41.76,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":37.55,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":37.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":38.60,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":37.55,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":38.60,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":37.55,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":38.25,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":38.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":36.84,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":31.81,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":41.76,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":36.84,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":35.09,"methodology":"fee schedule"}]}]},{"description":"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript ","code_information":[{"code":"87505","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":116.27,"maximum":152.67,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":128.29,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":137.27,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":135.99,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":130.86,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":130.86,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":141.12,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":137.27,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":141.12,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":137.27,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":139.84,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":128.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":141.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":134.70,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":116.27,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":128.29,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":152.67,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":134.70,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":130.86,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":128.29,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":128.29,"methodology":"fee schedule"}]}]},{"description":"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ","code_information":[{"code":"87623","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":31.81,"maximum":41.76,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":37.55,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":37.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":38.60,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":37.55,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":38.60,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":37.55,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":38.25,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":38.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":36.84,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":31.81,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":41.76,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":36.84,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":35.09,"methodology":"fee schedule"}]}]},{"description":"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ","code_information":[{"code":"709443","type":"CDM"},{"code":"87661","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":31.81,"maximum":41.76,"gross_charge":33.00,"discounted_cash":33.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":37.55,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":37.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":38.60,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":37.55,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":38.60,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":37.55,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":38.25,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":38.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":36.84,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":31.81,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":41.76,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":36.84,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":35.09,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":35.09,"methodology":"fee schedule"}]}]},{"description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.) ","code_information":[{"code":"E0782","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU|KF","modifiers_description":"New equipment|Item designated by FDA as Class III device","setting":"outpatient","minimum":5682.41,"maximum":6443.97,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5858.15,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6268.22,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6209.64,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5975.31,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5975.31,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6443.97,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6268.22,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":6443.97,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6268.22,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6385.38,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5858.15,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6443.97,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6151.06,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":5682.41,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5858.15,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6151.06,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5975.31,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5858.15,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5858.15,"methodology":"fee schedule"}]}]},{"description":"Inj cladribine ","code_information":[{"code":"858","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":14.24,"maximum":15.67,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14.24,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":15.24,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":15.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14.53,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14.53,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15.67,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":15.24,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":15.67,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":15.24,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":15.53,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":14.24,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15.67,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14.96,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":14.24,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":14.96,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14.53,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14.24,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14.24,"methodology":"fee schedule"}]}]},{"description":"Inj inotuzumab ozogam 0.1 ","code_information":[{"code":"9028","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":2618.85,"maximum":2880.73,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2618.85,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2802.17,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2775.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2671.22,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2671.22,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2880.73,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2802.17,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2880.73,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2802.17,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2854.54,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2618.85,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2880.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2749.79,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2618.85,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2749.79,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2671.22,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2618.85,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2618.85,"methodology":"fee schedule"}]}]},{"description":"Inj xipere 1 mg ","code_information":[{"code":"9358","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":48.40,"maximum":53.24,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":48.40,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":51.79,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":51.30,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":49.37,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":49.37,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":53.24,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":51.79,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":53.24,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":51.79,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":52.75,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":48.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":53.24,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":50.82,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":48.40,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":50.82,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":49.37,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":48.40,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":48.40,"methodology":"fee schedule"}]}]},{"description":"Inj, cefiderocol, 10 mg ","code_information":[{"code":"9426","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":2.27,"maximum":2.50,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2.27,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2.43,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2.41,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2.31,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2.31,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2.43,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2.43,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2.47,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2.27,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2.38,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2.27,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2.38,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2.31,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2.27,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2.27,"methodology":"fee schedule"}]}]},{"description":"Inj, levothyroxine, fresk ","code_information":[{"code":"734","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":3.75,"maximum":4.12,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3.75,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4.01,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3.97,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3.82,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3.82,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.12,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4.01,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.12,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4.01,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.08,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3.75,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3.93,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3.75,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3.93,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3.82,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3.75,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3.75,"methodology":"fee schedule"}]}]},{"description":"Inj, Omacetaxine Mep, 0.0 ","code_information":[{"code":"9297","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":4.03,"maximum":4.43,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4.03,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4.31,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4.27,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4.11,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4.11,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.43,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4.31,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.43,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4.31,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.39,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4.03,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.43,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4.23,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4.03,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4.23,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4.11,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4.03,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4.03,"methodology":"fee schedule"}]}]},{"description":"Inj. (ani), up to 40 unit ","code_information":[{"code":"9275","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":3416.97,"maximum":3758.67,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3416.97,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3656.16,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3621.99,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3485.31,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3485.31,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3758.67,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3656.16,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3758.67,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3656.16,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3724.50,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3416.97,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3758.67,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3587.82,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3416.97,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3587.82,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3485.31,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3416.97,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3416.97,"methodology":"fee schedule"}]}]},{"description":"Inj., fibryga, 1 mg ","code_information":[{"code":"9046","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":1.11,"maximum":1.22,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1.11,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1.19,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1.18,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1.13,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1.13,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1.22,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1.19,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1.22,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1.19,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1.21,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1.11,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1.22,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1.17,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1.11,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1.17,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1.13,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1.11,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1.11,"methodology":"fee schedule"}]}]},{"description":"Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ","code_information":[{"code":"80432","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":150.11,"maximum":197.08,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":165.61,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":177.20,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":175.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":168.92,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":168.92,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":182.17,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":177.20,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":182.17,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":177.20,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":180.51,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":165.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":182.17,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":173.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":150.11,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":165.61,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":197.08,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":173.89,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":168.92,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":165.61,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":165.61,"methodology":"fee schedule"}]}]},{"description":"INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/ ","code_information":[{"code":"022","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":248327.44,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":30614.20,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":80660.00,"methodology":"case rate"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":30920.34,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":80660.00,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_dollar":44854.00,"methodology":"case rate"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":33369.48,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":32451.05,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":74994.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":35719.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":68861.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":69988.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":97505.63,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":69988.31,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":30920.34,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":30920.34,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":103029.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":248327.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":103029.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":69988.31,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":33675.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":56338.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":89989.90,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":32451.05,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":33369.48,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":30614.20,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":33369.48,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":31991.84,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":29695.77,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":32451.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":38267.75,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":30614.20,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":30614.20,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":30614.20,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":29997.81,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":34134.83,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":30614.20,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":142424.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 16. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":29267.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":106435.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 16. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":30614.20,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":30614.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":30001.92,"methodology":"fee schedule"}]}]},{"description":"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A ","code_information":[{"code":"061","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":77289.14,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":23545.12,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":23780.57,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":25664.18,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":24957.83,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":21783.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":30347.54,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":21783.08,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":23780.57,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":23780.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":32066.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":77289.14,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":32066.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":21783.08,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":25899.63,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":43137.67,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":68904.57,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":24957.83,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":25664.18,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":23545.12,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":25664.18,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":23333.21,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":22838.77,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":24957.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":29431.40,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":23545.12,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":23545.12,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":23545.12,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":22969.09,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":26252.81,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":23545.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":22509.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":23545.12,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":23545.12,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":23074.22,"methodology":"fee schedule"}]}]},{"description":"KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC ","code_information":[{"code":"656","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":94942.56,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":28283.76,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":28566.60,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":30829.30,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":29980.79,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":26758.50,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":37279.14,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":26758.50,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":28566.60,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":28566.60,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":39391.00,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":94942.56,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":39391.00,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":26758.50,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":31112.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":51986.38,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":83038.77,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":29980.79,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":30829.30,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":28283.76,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":30829.30,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":28029.21,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":27435.25,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":29980.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":35354.70,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":28283.76,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":28283.76,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":28283.76,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":27680.68,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":31536.39,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":28283.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":27039.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":28283.76,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":28283.76,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":27718.08,"methodology":"fee schedule"}]}]},{"description":"KLF1 (Kruppel-like factor 1), targeted sequencing (ie, exon 13) ","code_information":[{"code":"0195U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":375.25,"maximum":446.55,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":375.25,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":401.52,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":397.77,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":382.75,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":382.75,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":412.78,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":401.52,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":412.78,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":401.52,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":409.02,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":375.25,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":412.78,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":394.01,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":375.25,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":446.55,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":394.01,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":382.75,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":375.25,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":375.25,"methodology":"fee schedule"}]}]},{"description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specifi ","code_information":[{"code":"L1847","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":660.04,"maximum":748.50,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":680.45,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":728.08,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":721.28,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":694.06,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":694.06,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":748.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":728.08,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":748.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":728.08,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":741.69,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":680.45,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":748.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":714.47,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":660.04,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":680.45,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":714.47,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":694.06,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":680.45,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":680.45,"methodology":"fee schedule"}]}]},{"description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only ","code_information":[{"code":"Q0487","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":392.46,"maximum":445.06,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":404.60,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":432.92,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":428.88,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":412.69,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":412.69,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":445.06,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":432.92,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":445.06,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":432.92,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":441.01,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":404.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":445.06,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":424.83,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":392.46,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":404.60,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":424.83,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":412.69,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":404.60,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":404.60,"methodology":"fee schedule"}]}]},{"description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens ","code_information":[{"code":"V2783","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":83.45,"maximum":94.63,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":86.03,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":92.05,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":91.19,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":87.75,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":87.75,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":94.63,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":92.05,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":94.63,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":92.05,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":93.77,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":86.03,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":94.63,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":90.33,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":83.45,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":86.03,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":90.33,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":87.75,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":86.03,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":86.03,"methodology":"fee schedule"}]}]},{"description":"Level 1 Pacemaker and Sim ","code_information":[{"code":"5221","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":3615.00,"maximum":3976.50,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3615.00,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3868.05,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3831.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3687.30,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3687.30,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3976.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3868.05,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3976.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3868.05,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3940.35,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3615.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3976.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3795.75,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3615.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3795.75,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3687.30,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3615.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3615.00,"methodology":"fee schedule"}]}]},{"description":"Level 2 Lower GI Procedur ","code_information":[{"code":"5312","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":1086.31,"maximum":1194.94,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1086.31,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1162.35,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1151.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1108.04,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1108.04,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1194.94,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1162.35,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1194.94,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1162.35,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1184.08,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1086.31,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1194.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1140.63,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1086.31,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1140.63,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1108.04,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1086.31,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1086.31,"methodology":"fee schedule"}]}]},{"description":"Level 3 Radiation Therapy ","code_information":[{"code":"5623","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":541.89,"maximum":596.08,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":541.89,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":579.82,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":574.40,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":552.73,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":552.73,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":596.08,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":579.82,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":596.08,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":579.82,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":590.66,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":541.89,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":596.08,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":568.98,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":541.89,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":568.98,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":552.73,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":541.89,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":541.89,"methodology":"fee schedule"}]}]},{"description":"Level 5 Intraocular Proce ","code_information":[{"code":"5495","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":14529.52,"maximum":15982.47,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14529.52,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":15546.59,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":15401.29,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14820.11,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14820.11,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15982.47,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":15546.59,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":15982.47,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":15546.59,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":15837.18,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":14529.52,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15982.47,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":15256.00,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":14529.52,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":15256.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14820.11,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14529.52,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14529.52,"methodology":"fee schedule"}]}]},{"description":"lisocabtagene car pos t ","code_information":[{"code":"9413","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":516726.10,"maximum":568398.71,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":516726.10,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":552896.93,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":547729.67,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":527060.62,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":527060.62,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":568398.71,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":552896.93,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":568398.71,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":552896.93,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":563231.45,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":516726.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":568398.71,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":542562.41,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":516726.10,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":542562.41,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":527060.62,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":516726.10,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":516726.10,"methodology":"fee schedule"}]}]},{"description":"Lubricant, individual sterile packet, each ","code_information":[{"code":"A4332","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":0.15,"maximum":0.17,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":0.15,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":0.16,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":0.16,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":0.15,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":0.15,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":0.17,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":0.16,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":0.17,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":0.16,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":0.16,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":0.15,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":0.17,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":0.16,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":0.15,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":0.15,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":0.16,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":0.15,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":0.15,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":0.15,"methodology":"fee schedule"}]}]},{"description":"Lumizyme injection ","code_information":[{"code":"1413","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":201.97,"maximum":222.16,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":201.97,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":216.10,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":214.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":206.00,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":206.00,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":222.16,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":216.10,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":222.16,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":216.10,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":220.14,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":201.97,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":222.16,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":212.06,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":201.97,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":212.06,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":206.00,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":201.97,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":201.97,"methodology":"fee schedule"}]}]},{"description":"LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC ","code_information":[{"code":"820","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":148400.23,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":50196.89,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":50698.86,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":54714.61,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 11. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":53208.70,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 11. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":32806.93,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":45705.64,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":32806.93,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":50698.86,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":50698.86,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":48294.86,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":116403.16,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":48294.86,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":32806.93,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":55216.58,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":92905.88,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":148400.23,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":53208.70,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":54714.61,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 11. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":50196.89,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":54714.61,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":49745.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":48690.98,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":53208.70,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":62746.11,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":50196.89,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":50196.89,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":50196.89,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":49468.68,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":55969.53,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":50196.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":47988.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":50196.89,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":50196.89,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":49192.95,"methodology":"fee schedule"}]}]},{"description":"MAJOR ESOPHAGEAL DISORDERS WITH MCC ","code_information":[{"code":"368","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":42565.75,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":14714.75,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14861.90,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16039.08,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":15597.64,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":10784.43,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":15024.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":10784.43,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14861.90,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14861.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":15875.69,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":38264.54,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":15875.69,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":10784.43,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":16186.23,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":26648.26,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":42565.75,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":15597.64,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16039.08,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":14714.75,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16039.08,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14582.32,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14273.31,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":15597.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18393.44,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":14714.75,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":14714.75,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":14714.75,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":14189.14,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":16406.95,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14714.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":14067.30,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14714.75,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":14714.75,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14420.45,"methodology":"fee schedule"}]}]},{"description":"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC ","code_information":[{"code":"723","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":29467.07,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":10040.20,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":10140.60,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":10943.82,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10642.61,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":8304.96,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":11570.23,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":8304.96,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":10140.60,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":10140.60,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":12225.68,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":29467.07,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":12225.68,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":8304.96,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":11044.22,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":17919.24,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":28622.72,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10642.61,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10943.82,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":10040.20,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":10943.82,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":9949.84,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9738.99,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":10642.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12550.25,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":10040.20,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":10040.20,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":10040.20,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":9541.28,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":11194.82,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":10040.20,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":9598.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":10040.20,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":10040.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":9839.40,"methodology":"fee schedule"}]}]},{"description":"Manual wheelchair accessory, pneumatic caster tire, any size, each ","code_information":[{"code":"E2214","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":34.93,"maximum":39.61,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":36.01,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":38.53,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":38.17,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":36.73,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":36.73,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":39.61,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":38.53,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":39.61,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":38.53,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":39.25,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":36.01,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":39.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":37.81,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":34.93,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":36.01,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":37.81,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":36.73,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":36.01,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":36.01,"methodology":"fee schedule"}]}]},{"description":"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ","code_information":[{"code":"81302","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":527.87,"maximum":628.17,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":527.87,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":564.82,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":559.54,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":538.43,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":538.43,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":580.66,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":564.82,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":580.66,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":564.82,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":575.38,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":527.87,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":580.66,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":554.26,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":527.87,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":628.17,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":554.26,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":538.43,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":527.87,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":527.87,"methodology":"fee schedule"}]}]},{"description":"Metacarpophalangeal joint implant ","code_information":[{"code":"L8630","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":383.04,"maximum":434.38,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":394.89,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":422.53,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":418.58,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":402.79,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":402.79,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":434.38,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":422.53,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":434.38,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":422.53,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":430.43,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":394.89,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":434.38,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":414.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":383.04,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":394.89,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":414.63,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":402.79,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":394.89,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":394.89,"methodology":"fee schedule"}]}]},{"description":"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ","code_information":[{"code":"81292","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":675.40,"maximum":803.73,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":675.40,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":722.68,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":715.92,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":688.91,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":688.91,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":742.94,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":722.68,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":742.94,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":722.68,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":736.19,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":675.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":742.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":709.17,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":675.40,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":803.73,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":709.17,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":688.91,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":675.40,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":675.40,"methodology":"fee schedule"}]}]},{"description":"Mouth piece ","code_information":[{"code":"A4617","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":4.10,"maximum":4.65,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4.23,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4.53,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4.48,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4.31,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4.31,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.65,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4.53,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.65,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4.53,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.61,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4.23,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.65,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4.44,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4.10,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4.23,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4.44,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4.31,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4.23,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4.23,"methodology":"fee schedule"}]}]},{"description":"Multipositional patient support system, with integrated lift, patient accessible controls ","code_information":[{"code":"E0636","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":1122.88,"maximum":1273.37,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1157.61,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1238.64,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1227.07,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1180.76,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1180.76,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1273.37,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1238.64,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1273.37,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1238.64,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1261.79,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1157.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1273.37,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1215.49,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1122.88,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1157.61,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1215.49,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1180.76,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1157.61,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1157.61,"methodology":"fee schedule"}]}]},{"description":"MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. ","code_information":[{"code":"828","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":58892.86,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":14141.33,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14282.74,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":15414.05,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":14989.81,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":16598.29,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":23124.25,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":16598.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":14282.74,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":14282.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":24434.24,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":58892.86,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":24434.24,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":16598.29,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":15555.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":25577.48,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":40855.37,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":14989.81,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":15414.05,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":14141.33,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":15414.05,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14014.06,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":13717.09,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":14989.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":17676.66,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":14141.33,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":14141.33,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":14141.33,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":13618.99,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":15767.58,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":14141.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":13519.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14141.33,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":14141.33,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":13858.50,"methodology":"fee schedule"}]}]},{"description":"Neurology Alzheimer Disease Cell Aggregation ","code_information":[{"code":"0206U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":2215.40,"maximum":2636.33,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2215.40,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2370.48,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2348.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2259.71,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2259.71,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2436.94,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2370.48,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2436.94,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2370.48,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2414.79,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2215.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2436.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2326.17,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2215.40,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":2636.33,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2326.17,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2259.71,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2215.40,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2215.40,"methodology":"fee schedule"}]}]},{"description":"New Technology  - Level 1 ","code_information":[{"code":"1499","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":34.30,"maximum":37.73,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":34.30,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":36.70,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":36.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":34.98,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":34.98,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":37.73,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":36.70,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":37.73,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":36.70,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":37.39,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":34.30,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":37.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":36.01,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":34.30,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":36.01,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":34.98,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":34.30,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":34.30,"methodology":"fee schedule"}]}]},{"description":"New Technology - Level 20 ","code_information":[{"code":"1520","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":1787.88,"maximum":1966.67,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1787.88,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1913.03,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1895.15,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1823.64,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1823.64,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1966.67,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1913.03,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1966.67,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1913.03,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1948.79,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1787.88,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1966.67,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1877.27,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1787.88,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1877.27,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1823.64,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1787.88,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1787.88,"methodology":"fee schedule"}]}]},{"description":"New Technology - Level 38 ","code_information":[{"code":"1575","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":12077.48,"maximum":13285.23,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12077.48,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":12922.90,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":12802.13,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":12319.03,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":12319.03,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":13285.23,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":12922.90,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":13285.23,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":12922.90,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13164.45,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":12077.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":13285.23,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":12681.35,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12077.48,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":12681.35,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":12319.03,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12077.48,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12077.48,"methodology":"fee schedule"}]}]},{"description":"NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC ","code_information":[{"code":"988","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":60051.87,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":15108.71,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15259.80,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16468.49,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16015.23,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":16924.95,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":23579.33,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":16924.95,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15259.80,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15259.80,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":24915.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":60051.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":24915.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":16924.95,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":16619.58,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":27383.93,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":43740.84,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16015.23,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16468.49,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":15108.71,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16468.49,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14972.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14655.45,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":16015.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18885.89,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":15108.71,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":15108.71,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":15108.71,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":14580.85,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":16846.21,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15108.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":14443.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15108.71,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":15108.71,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14806.54,"methodology":"fee schedule"}]}]},{"description":"NORMAL NEWBORN ","code_information":[{"code":"795","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":356.00,"maximum":11098.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":2151.58,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":839.00,"methodology":"per diem"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2173.10,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":839.00,"methodology":"per diem"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2345.22,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2280.67,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":1181.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":1649.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":1181.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2173.10,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2173.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":1703.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":2331.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":1703.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":1181.00,"methodology":"case rate"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2366.74,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2280.67,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2345.22,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":2151.58,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2345.22,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2132.22,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2087.03,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":2280.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2689.47,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":2151.58,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":2151.58,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":2151.58,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2399.01,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2151.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":600.00,"methodology":"per diem","additional_payer_notes":" If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":2056.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":356.00,"methodology":"per diem","additional_payer_notes":" If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2151.58,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":2151.58,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2108.55,"methodology":"fee schedule"}]}]},{"description":"Omalizumab injection ","code_information":[{"code":"9300","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":38.29,"maximum":42.12,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":38.29,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":40.97,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":40.59,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":39.06,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":39.06,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":42.12,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":40.97,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":42.12,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":40.97,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":41.74,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":38.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":42.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":40.21,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":38.29,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":40.21,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":39.06,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":38.29,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":38.29,"methodology":"fee schedule"}]}]},{"description":"Oncology (breast), semiquantitative analysis of 32 phosphoproteins and protein analytes, incl laser capture microdissection, w algorithmic analysis and interpretative report ","code_information":[{"code":"0249U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":2219.13,"maximum":2640.76,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2219.13,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2374.47,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2352.28,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2263.51,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2263.51,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2441.04,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2374.47,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2441.04,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2374.47,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2418.85,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2219.13,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2441.04,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2330.09,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2219.13,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":2640.76,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2330.09,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2263.51,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2219.13,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2219.13,"methodology":"fee schedule"}]}]},{"description":"Oncology (lung), three protein biomarkers, immunoassay using Q4 magnetic nanosensor technology, plasma, algorithm reported as risk score for likelihood of malignancy ","code_information":[{"code":"0092U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":2488.00,"maximum":2960.72,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2488.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2662.16,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2637.28,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2537.76,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2537.76,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2736.80,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2662.16,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2736.80,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2662.16,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2711.92,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2488.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2736.80,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2612.40,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2488.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":2960.72,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2612.40,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2537.76,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2488.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2488.00,"methodology":"fee schedule"}]}]},{"description":"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ","code_information":[{"code":"81546","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3600.00,"maximum":4284.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3600.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3852.00,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3816.00,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3672.00,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3672.00,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3960.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3852.00,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3960.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3852.00,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3924.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3600.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3960.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3780.00,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3600.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":4284.00,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3780.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3672.00,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3600.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3600.00,"methodology":"fee schedule"}]}]},{"description":"Oncology, response to radiation, cell-free DNA, quantitative branched chain DNA amplfication, plasma, reported as a radiation toxicity score ","code_information":[{"code":"0285U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":443.31,"maximum":527.54,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":443.31,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":474.34,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":469.91,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":452.18,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":452.18,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":487.64,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":474.34,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":487.64,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":474.34,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":483.21,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":443.31,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":487.64,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":465.48,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":443.31,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":527.54,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":465.48,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":452.18,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":443.31,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":443.31,"methodology":"fee schedule"}]}]},{"description":"Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis) ","code_information":[{"code":"L3225","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":72.19,"maximum":81.86,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":74.42,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":79.63,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":78.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":75.91,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":75.91,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":81.86,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":79.63,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":81.86,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":79.63,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":81.12,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":74.42,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":81.86,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":78.14,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":72.19,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":74.42,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":78.14,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":75.91,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":74.42,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":74.42,"methodology":"fee schedule"}]}]},{"description":"Osmolality; blood ","code_information":[{"code":"684500","type":"CDM"},{"code":"83930","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":5.99,"maximum":7.87,"gross_charge":730.84,"discounted_cash":730.84,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":6.61,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":7.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7.01,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6.74,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6.74,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7.27,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":7.07,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":7.27,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7.07,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7.20,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":6.61,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7.27,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":5.99,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":6.61,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7.87,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6.94,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6.74,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6.61,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6.61,"methodology":"fee schedule"}]}]},{"description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each ","code_information":[{"code":"A4416","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":3.65,"maximum":4.14,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3.76,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4.02,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3.99,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3.84,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3.84,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4.14,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4.02,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4.14,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4.02,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4.10,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3.76,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4.14,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3.95,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3.76,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3.95,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3.84,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3.76,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3.76,"methodology":"fee schedule"}]}]},{"description":"NON-EXTENSIVE BURNS ","code_information":[{"code":"935","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":55983.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":19213.26,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":19405.39,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":20942.45,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":20366.06,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":11272.96,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":15705.15,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":11272.96,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19405.39,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19405.39,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":16594.85,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":39997.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":16594.85,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":11272.96,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":21134.59,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":35048.56,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":55983.69,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":20366.06,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_percentage":40.00,"standard_charge_algorithm":"Reimbursement will be 40% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":20942.45,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":19213.26,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":20942.45,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":19040.34,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":18636.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":20366.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":24016.57,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":19213.26,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":19213.26,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":19213.26,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":25.00,"standard_charge_algorithm":"Reimbursement will be 25% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":21422.78,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19213.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":18367.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":19213.26,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":19213.26,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18828.99,"methodology":"fee schedule"}]}]},{"description":"Oncology (breast), augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features, reported as a recurrence score ","code_information":[{"code":"0418U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":706.25,"maximum":840.44,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":706.25,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":755.69,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":748.63,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":720.38,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":720.38,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":776.88,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":755.69,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":776.88,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":755.69,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":769.81,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":706.25,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":776.88,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":741.56,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":706.25,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":840.44,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":741.56,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":720.38,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":706.25,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":706.25,"methodology":"fee schedule"}]}]},{"description":"Oncology (prostate), detection of 8 autoantibodies (ARF 6, NKX3-1, 5'-UTR-BMI1, CEP 164, 3'-UTR-Ropporin, Desmocollin, AURKAIP-1, CSNK2A2), multiplexed immunoassay and flow cytometry serum, algorithm ","code_information":[{"code":"0021U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":760.00,"maximum":904.40,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":760.00,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":813.20,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":805.60,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":775.20,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":775.20,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":836.00,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":813.20,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":836.00,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":813.20,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":828.40,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":760.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":836.00,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":798.00,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":760.00,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":904.40,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":798.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":775.20,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":760.00,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":760.00,"methodology":"fee schedule"}]}]},{"description":"OSTEOMYELITIS WITH MCC ","code_information":[{"code":"539","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":56647.06,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":17729.71,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17907.01,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19325.38,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":18793.49,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":15965.34,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":22242.44,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":15965.34,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17907.01,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17907.01,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":23502.47,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":56647.06,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":23502.47,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":15965.34,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19502.68,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":32278.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":51558.62,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":18793.49,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19325.38,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":17729.71,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":19325.38,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":17570.14,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":17197.82,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":18793.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":22162.14,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":17729.71,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":17729.71,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":17729.71,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":17186.88,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19768.63,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":17729.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":16949.60,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17729.71,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":17729.71,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":17375.12,"methodology":"fee schedule"}]}]},{"description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each ","code_information":[{"code":"A4393","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":11.96,"maximum":13.56,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12.33,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13.19,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13.07,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":12.58,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":12.58,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":13.56,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13.19,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":13.56,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13.19,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13.44,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":12.33,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":13.56,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":12.95,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":11.96,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12.33,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":12.95,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":12.58,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12.33,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12.33,"methodology":"fee schedule"}]}]},{"description":"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC ","code_information":[{"code":"629","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":79545.26,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":19673.02,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":19869.75,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":21443.59,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":20853.40,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":22418.94,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":31233.40,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":22418.94,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19869.75,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19869.75,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":33002.77,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":79545.26,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":33002.77,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":22418.94,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":21640.32,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":35907.10,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":57355.05,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":20853.40,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":21443.59,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":19673.02,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":21443.59,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":19495.96,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19082.83,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":20853.40,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":24591.28,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":19673.02,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":19673.02,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":19673.02,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":19119.10,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":21935.42,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19673.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":18807.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":19673.02,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":19673.02,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":19279.56,"methodology":"fee schedule"}]}]},{"description":"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) mRNA sequence analysis (List separately in additional to code for primary procedure) ","code_information":[{"code":"0137U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":282.88,"maximum":336.63,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":282.88,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":302.68,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":299.85,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":288.54,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":288.54,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":311.17,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":302.68,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":311.17,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":302.68,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":308.34,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":282.88,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":311.17,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":297.02,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":282.88,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":336.63,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":297.02,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":288.54,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":282.88,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":282.88,"methodology":"fee schedule"}]}]},{"description":"Pegaspargase injection ","code_information":[{"code":"843","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":27070.53,"maximum":29777.58,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":27070.53,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":28965.47,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":28694.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":27611.94,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":27611.94,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":29777.58,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":28965.47,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":29777.58,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":28965.47,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":29506.88,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":27070.53,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":29777.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":28424.06,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":27070.53,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":28424.06,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":27611.94,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":27070.53,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":27070.53,"methodology":"fee schedule"}]}]},{"description":"Platelets, each unit ","code_information":[{"code":"9515","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":65.04,"maximum":71.54,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":65.04,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":69.59,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":68.94,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":66.34,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":66.34,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":71.54,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":69.59,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":71.54,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":69.59,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":70.89,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":65.04,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":71.54,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":68.29,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":65.04,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":68.29,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":66.34,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":65.04,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":65.04,"methodology":"fee schedule"}]}]},{"description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds ","code_information":[{"code":"K0801","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":1744.11,"maximum":1977.86,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1798.05,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1923.91,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1905.93,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1834.01,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1834.01,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1977.86,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1923.91,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1977.86,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1923.91,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1959.87,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1798.05,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1977.86,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1887.95,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1744.11,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1798.05,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1887.95,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1834.01,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1798.05,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1798.05,"methodology":"fee schedule"}]}]},{"description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds ","code_information":[{"code":"K0858","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":1204.21,"maximum":1365.60,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1241.45,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1328.35,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1315.94,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1266.28,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1266.28,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1365.60,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1328.35,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1365.60,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1328.35,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1353.18,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1241.45,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1365.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1303.52,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1204.21,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1241.45,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1303.52,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1266.28,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1241.45,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1241.45,"methodology":"fee schedule"}]}]},{"description":"Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes ","code_information":[{"code":"97761","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":39.08,"maximum":44.32,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":40.29,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":43.11,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":42.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":41.10,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":41.10,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":44.32,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":43.11,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":44.32,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":43.11,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":43.92,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":40.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":44.32,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":42.30,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":39.08,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":40.29,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":42.30,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":41.10,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":40.29,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":40.29,"methodology":"fee schedule"}]}]},{"description":"Radiation tx delivery imr ","code_information":[{"code":"4015","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":328.73,"maximum":361.60,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":328.73,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":351.74,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":348.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":335.30,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":335.30,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":361.60,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":351.74,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":361.60,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":351.74,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":358.31,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":328.73,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":361.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":345.16,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":328.73,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":345.16,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":335.30,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":328.73,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":328.73,"methodology":"fee schedule"}]}]},{"description":"RENAL FAILURE WITH MCC ","code_information":[{"code":"682","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":45431.83,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":13279.91,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":13412.71,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":14475.10,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":14076.70,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":12804.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":17838.78,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":12804.45,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":13412.71,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":13412.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":18849.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":45431.83,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":18849.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":12804.45,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":14607.90,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":23968.92,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":38285.98,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":14076.70,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":14475.10,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":13279.91,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":14475.10,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":13160.39,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":12881.51,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":14076.70,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":16599.89,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":13279.91,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":13279.91,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":13279.91,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":12762.49,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":14807.10,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":13279.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":12695.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":13279.91,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":13279.91,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":13014.31,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY NEOPLASMS WITH MCC ","code_information":[{"code":"180","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":44548.87,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":15379.61,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15533.41,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16763.77,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16302.39,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":10912.38,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":15202.80,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":10912.38,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15533.41,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15533.41,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":16064.04,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":38718.51,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":16064.04,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":10912.38,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":16917.57,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":27889.80,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":44548.87,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16302.39,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16763.77,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":15379.61,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16763.77,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15241.19,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14918.22,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":16302.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":19224.51,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":15379.61,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":15379.61,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":15379.61,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":14850.21,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":17148.27,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15379.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":14702.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15379.61,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":15379.61,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15072.02,"methodology":"fee schedule"}]}]},{"description":"Salicylate ","code_information":[{"code":"80179","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":16.90,"maximum":22.18,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":19.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":20.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19.57,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.90,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":22.18,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19.57,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18.64,"methodology":"fee schedule"}]}]},{"description":"SEPTIC ARTHRITIS WITHOUT CC/MCC ","code_information":[{"code":"550","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":50081.63,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":7811.46,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7889.57,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":8514.49,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":8280.15,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":14114.95,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":19664.52,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":14114.95,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":7889.57,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":7889.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":20778.52,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":50081.63,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":20778.52,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":14114.95,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8592.60,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":13757.39,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":21974.93,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":8280.15,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":8514.49,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":7811.46,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8514.49,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7741.16,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7577.12,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":8280.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":9764.32,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":7811.46,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":7811.46,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":7811.46,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7325.26,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8709.78,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":7811.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":7467.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":7811.46,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":7811.46,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7655.23,"methodology":"fee schedule"}]}]},{"description":"SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC ","code_information":[{"code":"195","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":30409.41,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":5766.45,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":28103.00,"methodology":"case rate"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5824.12,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_dollar":28103.00,"methodology":"case rate"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6285.43,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6112.44,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":13701.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":19234.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":13701.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5824.12,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5824.12,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":20542.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":30409.41,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":20542.00,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":13701.00,"methodology":"case rate"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6343.10,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":9938.64,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":15875.17,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6112.44,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6285.43,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":5766.45,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6285.43,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5714.55,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5593.46,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":6112.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7208.06,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":5766.45,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":5766.45,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":5766.45,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5291.93,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6429.59,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5766.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":5512.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5766.45,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":5766.45,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5651.12,"methodology":"fee schedule"}]}]},{"description":"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ","code_information":[{"code":"89331","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":17.75,"maximum":23.31,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":19.59,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":20.96,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":20.77,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19.98,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19.98,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":21.55,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":20.96,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":21.55,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":20.96,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":21.35,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":19.59,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":21.55,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":20.57,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":17.75,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":19.59,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":23.31,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":20.57,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19.98,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":19.59,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":19.59,"methodology":"fee schedule"}]}]},{"description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molde ","code_information":[{"code":"L4396","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":192.61,"maximum":218.43,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":198.57,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":212.47,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":210.48,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":202.54,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":202.54,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":218.43,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":212.47,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":218.43,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":212.47,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":216.44,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":198.57,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":218.43,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":208.50,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":192.61,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":198.57,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":208.50,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":202.54,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":198.57,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":198.57,"methodology":"fee schedule"}]}]},{"description":"Supprelin LA implant ","code_information":[{"code":"1142","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":45350.21,"maximum":49885.23,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":45350.21,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":48524.72,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":48071.22,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":46257.21,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":46257.21,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":49885.23,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":48524.72,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":49885.23,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":48524.72,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":49431.73,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":45350.21,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":49885.23,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":47617.72,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":45350.21,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":47617.72,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":46257.21,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":45350.21,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":45350.21,"methodology":"fee schedule"}]}]},{"description":"TESTES PROCEDURES WITH CC/MCC ","code_information":[{"code":"711","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":48701.19,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":16771.72,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":16939.44,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":18281.17,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":17778.02,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":8633.56,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":12028.01,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":8633.56,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":16939.44,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":16939.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":12709.40,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":30632.95,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":12709.40,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":8633.56,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":18448.89,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":30489.35,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":48701.19,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":17778.02,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":18281.17,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":16771.72,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":18281.17,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":16620.77,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":16268.57,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":17778.02,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":20964.65,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":16771.72,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":16771.72,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":16771.72,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16234.37,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18700.47,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":16771.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":16033.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":16771.72,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":16771.72,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":16436.29,"methodology":"fee schedule"}]}]},{"description":"Thyroxine binding globulin (TBG) ","code_information":[{"code":"84442","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":13.40,"maximum":17.59,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":14.78,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":15.81,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":15.67,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15.08,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15.08,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":16.26,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":15.81,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":16.26,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":15.81,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16.11,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":14.78,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":16.26,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":15.52,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":13.40,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":14.78,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":17.59,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":15.52,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15.08,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":14.78,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14.78,"methodology":"fee schedule"}]}]},{"description":"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ","code_information":[{"code":"81352","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":329.51,"maximum":392.12,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":329.51,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":352.58,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":349.28,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":336.10,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":336.10,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":362.46,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":352.58,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":362.46,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":352.58,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":359.17,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":329.51,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":362.46,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":345.99,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":329.51,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":392.12,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":345.99,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":336.10,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":329.51,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":329.51,"methodology":"fee schedule"}]}]},{"description":"Troponin, qualitative ","code_information":[{"code":"84512","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":9.15,"maximum":12.01,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":10.09,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":10.80,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10.70,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":10.29,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":10.29,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":11.10,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10.80,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":11.10,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10.80,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":11.00,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":10.09,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":11.10,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":10.59,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":9.15,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10.09,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":12.01,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":10.59,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":10.29,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":10.09,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":10.09,"methodology":"fee schedule"}]}]},{"description":"Upper extremity additions, shoulder abduction joint, pair ","code_information":[{"code":"L6640","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":379.45,"maximum":430.31,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":391.19,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":418.57,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":414.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":399.01,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":399.01,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":430.31,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":418.57,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":430.31,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":418.57,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":426.40,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":391.19,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":430.31,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":410.75,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":379.45,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":391.19,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":410.75,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":399.01,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":391.19,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":391.19,"methodology":"fee schedule"}]}]},{"description":"URINARY STONES WITHOUT MCC ","code_information":[{"code":"694","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":18372.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":7121.81,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7193.03,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":7762.78,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7549.12,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":16184.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":6532.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":14860.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":3970.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":5531.24,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":3970.25,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":7193.03,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":7193.03,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":5844.58,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":14086.96,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":5844.58,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":3970.25,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7833.99,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":14419.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":18372.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":7549.12,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7762.78,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":7121.81,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7762.78,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7057.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6908.16,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":7549.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8902.27,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":7121.81,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":7121.81,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":7121.81,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":6639.56,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":7940.82,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":7121.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":6808.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":7121.81,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":7121.81,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6979.38,"methodology":"fee schedule"}]}]},{"description":"von Willebrand factor (VWF), type 2B, platelet-binding evaluation, radioimmunoassay, plasma ","code_information":[{"code":"0283U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":18.40,"maximum":21.90,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":18.40,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19.69,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":19.50,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":18.77,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":18.77,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":20.24,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19.69,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":20.24,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.69,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":20.06,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":18.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":20.24,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.40,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":21.90,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":18.77,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18.40,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18.40,"methodology":"fee schedule"}]}]},{"description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each ","code_information":[{"code":"E1225","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":42.92,"maximum":48.68,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":44.25,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":47.35,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":46.91,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":45.13,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":45.13,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":48.68,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":47.35,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":48.68,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":47.35,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":48.23,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":44.25,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":48.68,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":46.46,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":42.92,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":44.25,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":46.46,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":45.13,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":44.25,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":44.25,"methodology":"fee schedule"}]}]},{"description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf ","code_information":[{"code":"L3916","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":555.15,"maximum":629.55,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":572.32,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":612.38,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":606.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":583.77,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":583.77,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":629.55,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":612.38,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":629.55,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":612.38,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":623.83,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":572.32,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":629.55,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":600.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":555.15,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":572.32,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":600.94,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":583.77,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":572.32,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":572.32,"methodology":"fee schedule"}]}]},{"description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each ","code_information":[{"code":"A4428","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":8.63,"maximum":9.79,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":8.90,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":9.52,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":9.43,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":9.08,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":9.08,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":9.79,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":9.52,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":9.79,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":9.52,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":9.70,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":8.90,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":9.79,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9.35,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":8.63,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8.90,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9.35,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":9.08,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8.90,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8.90,"methodology":"fee schedule"}]}]},{"description":"OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC ","code_information":[{"code":"750","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":630.00,"maximum":65637.13,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":11463.93,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":11578.57,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":12495.68,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":12151.77,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":18499.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":25772.38,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":18499.09,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":11578.57,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":11578.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":27232.39,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":65637.13,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":27232.39,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":18499.09,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":12610.32,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":20577.84,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":32869.36,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":12151.77,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":12495.68,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":11463.93,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":12495.68,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":11360.75,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":11120.01,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":12151.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":14329.91,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":11463.93,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":11463.93,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":11463.93,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":10956.88,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":12782.28,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":11463.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":10959.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":11463.93,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":11463.93,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":11234.65,"methodology":"fee schedule"}]}]},{"description":"Other scoliosis procedure, body jacket molded to patient model ","code_information":[{"code":"L1300","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1782.65,"maximum":2021.56,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1837.78,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1966.42,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1948.05,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1874.54,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1874.54,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2021.56,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1966.42,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2021.56,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1966.42,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2003.18,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1837.78,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2021.56,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1929.67,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1782.65,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1837.78,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1929.67,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1874.54,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1837.78,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1837.78,"methodology":"fee schedule"}]}]},{"description":"Pediatrics (congenital epigenetic disorders), whole genome methylation analysis by microarray for 50 or more genes, blood ","code_information":[{"code":"0318U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":1770.48,"maximum":2106.87,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1770.48,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1894.41,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1876.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1805.89,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1805.89,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1947.53,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1894.41,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1947.53,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":1894.41,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":1929.82,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":1770.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1947.53,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1859.00,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1770.48,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":2106.87,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1859.00,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1805.89,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1770.48,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1770.48,"methodology":"fee schedule"}]}]},{"description":"pH; body fluid, not otherwise specified ","code_information":[{"code":"83986","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":3.25,"maximum":4.26,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3.58,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3.83,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3.94,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3.83,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3.94,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3.83,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3.90,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3.76,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3.25,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3.58,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":4.26,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3.76,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3.58,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3.58,"methodology":"fee schedule"}]}]},{"description":"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ","code_information":[{"code":"81325","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":769.58,"maximum":915.80,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":769.58,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":823.45,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":815.75,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":784.97,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":784.97,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":846.54,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":823.45,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":846.54,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":823.45,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":838.84,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":769.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":846.54,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":808.06,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":769.58,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":915.80,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":808.06,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":784.97,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":769.58,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":769.58,"methodology":"fee schedule"}]}]},{"description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue ","code_information":[{"code":"E2377","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":52.77,"maximum":59.84,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":54.40,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":58.21,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":57.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":55.49,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":55.49,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":59.84,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":58.21,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":59.84,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":58.21,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":59.30,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":54.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":59.84,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":57.12,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":52.77,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":54.40,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":57.12,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":55.49,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":54.40,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":54.40,"methodology":"fee schedule"}]}]},{"description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds ","code_information":[{"code":"K0838","type":"HCPCS"}],"standard_charges":[{"modifiers":"RR","modifiers_description":"Rental (use the RR modifier when DME is to be rented)","setting":"outpatient","minimum":468.43,"maximum":531.21,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":482.92,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":516.72,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":511.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":492.58,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":492.58,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":531.21,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":516.72,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":531.21,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":516.72,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":526.38,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":482.92,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":531.21,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":507.07,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":468.43,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":482.92,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":507.07,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":492.58,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":482.92,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":482.92,"methodology":"fee schedule"}]}]},{"description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, ","code_information":[{"code":"L6590","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":3151.91,"maximum":3574.33,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3249.39,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3476.85,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3444.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3314.38,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3314.38,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3574.33,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3476.85,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3574.33,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3476.85,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3541.84,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3249.39,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3574.33,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3411.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":3151.91,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3249.39,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3411.86,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3314.38,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3249.39,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3249.39,"methodology":"fee schedule"}]}]},{"description":"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ","code_information":[{"code":"88372","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":26.22,"maximum":31.20,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":26.22,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":28.06,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":27.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":26.74,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":26.74,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":28.84,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":28.06,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":28.84,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":28.06,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":28.58,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":26.22,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":28.84,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":27.53,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":26.22,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":31.20,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":27.53,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":26.74,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":26.22,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":26.22,"methodology":"fee schedule"}]}]},{"description":"Rare diseases, whole genome sequence analysis, incl small sequence changes, copy number variants, deletions, duplications, mobile element insertions, UPD, inversions, aneuploidy, mitochondrial genome ","code_information":[{"code":"0335U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":5224.60,"maximum":6217.27,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5224.60,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":5590.32,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":5538.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5329.09,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5329.09,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":5747.06,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":5590.32,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":5747.06,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":5590.32,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":5694.81,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5224.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5747.06,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5485.83,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5224.60,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":6217.27,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":5485.83,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":5329.09,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5224.60,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5224.60,"methodology":"fee schedule"}]}]},{"description":"Red cell antigen (Kidd blood group) genotyping (JK), gene analysis, SLC14A1 (solute carrier family 14 member 1) gene promoter, exon 9 ","code_information":[{"code":"0192U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":274.83,"maximum":327.05,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":274.83,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":294.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":291.32,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":280.33,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":280.33,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":302.31,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":294.07,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":302.31,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":294.07,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":299.56,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":274.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":302.31,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":288.57,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":274.83,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":327.05,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":288.57,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":280.33,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":274.83,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":274.83,"methodology":"fee schedule"}]}]},{"description":"Respiratory infectious agent detection by nucleic acid (DNA and RNA), 18 viral types and subtypes and 2 bacterial targets, amplified probe technique, including multiplex reverse transcription for RNA ","code_information":[{"code":"0115U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":275.35,"maximum":327.67,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":275.35,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":294.62,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":291.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":280.86,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":280.86,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":302.89,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":294.62,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":302.89,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":294.62,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":300.13,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":275.35,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":302.89,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":289.12,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":275.35,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":327.67,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":289.12,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":280.86,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":275.35,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":275.35,"methodology":"fee schedule"}]}]},{"description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard ","code_information":[{"code":"A6453","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":0.83,"maximum":0.95,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":0.86,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":0.92,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":0.91,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":0.88,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":0.88,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":0.95,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":0.92,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":0.95,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":0.92,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":0.94,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":0.86,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":0.95,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":0.90,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":0.83,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":0.86,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":0.90,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":0.88,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":0.86,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":0.86,"methodology":"fee schedule"}]}]},{"description":"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ","code_information":[{"code":"87209","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":16.30,"maximum":21.40,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17.98,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19.24,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":19.06,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":18.34,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":18.34,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19.78,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19.24,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":19.78,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.24,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":19.60,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":17.98,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":19.78,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":18.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.30,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":17.98,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":21.40,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18.88,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":18.34,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17.98,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":17.98,"methodology":"fee schedule"}]}]},{"description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens ","code_information":[{"code":"V2104","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":42.83,"maximum":48.57,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":44.15,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":47.24,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":46.80,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":45.03,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":45.03,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":48.57,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":47.24,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":48.57,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":47.24,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":48.12,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":44.15,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":48.57,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":46.36,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":42.83,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":44.15,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":46.36,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":45.03,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":44.15,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":44.15,"methodology":"fee schedule"}]}]},{"description":"Tenecteplase injection ","code_information":[{"code":"9002","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":157.72,"maximum":173.50,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":157.72,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":168.76,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":167.19,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":160.88,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":160.88,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":173.50,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":168.76,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":173.50,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":168.76,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":171.92,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":157.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":173.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":165.61,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":157.72,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":165.61,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":160.88,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":157.72,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":157.72,"methodology":"fee schedule"}]}]},{"description":"Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing act ","code_information":[{"code":"97112","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","minimum":27.86,"maximum":30.65,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":27.86,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":29.81,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":29.53,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":28.42,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":28.42,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":30.65,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":29.81,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":30.65,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":29.81,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":30.37,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":27.86,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":30.65,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":29.26,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":27.86,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":29.26,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":28.42,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":27.86,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":27.86,"methodology":"fee schedule"}]}]},{"description":"Tracheostoma valve, including diaphragm, each ","code_information":[{"code":"A7501","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":138.99,"maximum":157.62,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":143.29,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":153.32,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":151.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":146.16,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":146.16,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":157.62,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":153.32,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":157.62,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":153.32,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":156.19,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":143.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":157.62,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":150.45,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":138.99,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":143.29,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":150.45,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":146.16,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":143.29,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":143.29,"methodology":"fee schedule"}]}]},{"description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing ","code_information":[{"code":"A6258","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":5.70,"maximum":6.47,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5.88,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6.29,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6.23,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6.00,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6.00,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6.47,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6.29,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":6.47,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6.29,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6.41,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5.88,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6.47,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6.17,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":5.70,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5.88,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6.17,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6.00,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":5.88,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5.88,"methodology":"fee schedule"}]}]},{"description":"Trypsin; duodenal fluid ","code_information":[{"code":"84485","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":6.53,"maximum":8.57,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7.20,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":7.70,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7.63,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":7.34,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":7.34,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7.92,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":7.70,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":7.92,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7.70,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7.85,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":7.20,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":7.92,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":6.53,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7.20,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":8.57,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":7.56,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":7.34,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":7.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7.20,"methodology":"fee schedule"}]}]},{"description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow ","code_information":[{"code":"L6677","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":341.11,"maximum":386.83,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":351.66,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":376.28,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":372.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":358.69,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":358.69,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":386.83,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":376.28,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":386.83,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":376.28,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":383.31,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":351.66,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":386.83,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":369.24,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":341.11,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":351.66,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":369.24,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":358.69,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":351.66,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":351.66,"methodology":"fee schedule"}]}]},{"description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w ","code_information":[{"code":"684770","type":"CDM"},{"code":"81001","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":2.87,"maximum":3.77,"gross_charge":1950.52,"discounted_cash":1950.52,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":3.17,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":3.39,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":3.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":3.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":3.23,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":3.49,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":3.39,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":3.49,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":3.39,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":3.46,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":3.17,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":3.49,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":3.33,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":2.87,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":3.17,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":3.77,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":3.33,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":3.23,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":3.17,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":3.17,"methodology":"fee schedule"}]}]},{"description":"Varicella-zoster ig, im ","code_information":[{"code":"9135","type":"APC"}],"standard_charges":[{"setting":"outpatient","minimum":2250.71,"maximum":2475.78,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2250.71,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2408.26,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2385.75,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":2295.72,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":2295.72,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":2475.78,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":2408.26,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":2475.78,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":2408.26,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":2453.27,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":2250.71,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":2475.78,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":2363.24,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":2250.71,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":2363.24,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":2295.72,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":2250.71,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":2250.71,"methodology":"fee schedule"}]}]},{"description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a s ","code_information":[{"code":"L4360","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":313.95,"maximum":356.03,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":323.66,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":346.32,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":343.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":330.13,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":330.13,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":356.03,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":346.32,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":356.03,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":346.32,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":352.79,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":323.66,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":356.03,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":339.84,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":313.95,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":323.66,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":339.84,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":330.13,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":323.66,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":323.66,"methodology":"fee schedule"}]}]},{"description":"Wheelchair accessory, tray, each ","code_information":[{"code":"E0950","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":86.66,"maximum":98.27,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":89.34,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":95.59,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":94.70,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":91.13,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":91.13,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":98.27,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":95.59,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":98.27,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":95.59,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":97.38,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":89.34,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":98.27,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":93.81,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":86.66,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":89.34,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":93.81,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":91.13,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":89.34,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":89.34,"methodology":"fee schedule"}]}]},{"description":"SCREW CANN 4.0X18 ","code_information":[{"code":"837835","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":708.92,"discounted_cash":708.92,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":184.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":63.80,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":163.05,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":354.46,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":567.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":652.21,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":425.35,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":602.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":602.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":531.69,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":354.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":602.58,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":354.46,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":187.86,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":319.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":124.06,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 4.0X22 ","code_information":[{"code":"837856","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":708.92,"discounted_cash":708.92,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":184.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":63.80,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":163.05,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":354.46,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":567.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":652.21,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":425.35,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":602.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":602.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":531.69,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":354.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":602.58,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":354.46,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":187.86,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":319.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":124.06,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 4.0X40 ","code_information":[{"code":"887555","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 6.5X100 ","code_information":[{"code":"886676","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":663.43,"discounted_cash":663.43,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":59.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":152.59,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":530.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":610.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":398.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":497.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":175.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":298.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":116.10,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 6.5X120X16MM ","code_information":[{"code":"931861","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":864.35,"discounted_cash":864.35,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":224.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":77.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":198.80,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":691.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":795.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":518.61,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":648.26,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":229.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":388.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":151.26,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 6.5X130X16MM ","code_information":[{"code":"931149","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":864.35,"discounted_cash":864.35,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":224.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":77.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":198.80,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":691.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":795.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":518.61,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":648.26,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":229.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":388.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":151.26,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 6.5X130X32MM ","code_information":[{"code":"931888","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":888.46,"discounted_cash":888.46,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":231.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":79.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":204.35,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":444.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":710.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":817.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":533.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":755.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":755.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":666.35,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":444.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":755.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":444.23,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":235.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":399.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":155.48,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 6.5X75 ","code_information":[{"code":"887564","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":663.43,"discounted_cash":663.43,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":59.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":152.59,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":530.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":610.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":398.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":497.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":175.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":298.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":116.10,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 6.5X80X32MM ","code_information":[{"code":"877516","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":888.46,"discounted_cash":888.46,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":231.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":79.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":204.35,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":444.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":710.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":817.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":533.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":755.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":755.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":666.35,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":444.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":755.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":444.23,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":235.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":399.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":155.48,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 6.5X85X32MM ","code_information":[{"code":"899628","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":864.35,"discounted_cash":864.35,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":224.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":77.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":198.80,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":691.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":795.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":518.61,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":648.26,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":229.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":388.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":151.26,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 6.5X95X40MM ","code_information":[{"code":"872730","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":802.48,"discounted_cash":802.48,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":208.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":72.22,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":184.57,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":401.24,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":641.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":738.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":481.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":682.11,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":682.11,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":601.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":401.24,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":682.11,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":401.24,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":212.66,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":361.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":140.43,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 7.3 X 65 SHTH ","code_information":[{"code":"837764","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":864.35,"discounted_cash":864.35,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":224.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":77.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":198.80,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":691.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":795.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":518.61,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":648.26,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":229.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":388.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":151.26,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 7.3X130X16MM ","code_information":[{"code":"837777","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":888.46,"discounted_cash":888.46,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":231.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":79.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":204.35,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":444.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":710.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":817.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":533.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":755.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":755.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":666.35,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":444.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":755.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":444.23,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":235.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":399.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":155.48,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 7.3X50X16MM ","code_information":[{"code":"837829","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":830.23,"discounted_cash":830.23,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":215.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":74.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":190.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":415.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":664.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":763.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":498.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":705.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":705.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":622.67,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":415.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":705.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":415.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":220.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":373.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":145.29,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN H/T 4.0X42 ","code_information":[{"code":"887597","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN L-T 4.0X45MM ","code_information":[{"code":"937696","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":815.07,"discounted_cash":815.07,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":211.92,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":73.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":187.47,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":407.54,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":652.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":749.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":489.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":692.81,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":692.81,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":611.30,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":407.54,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":692.81,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":407.54,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":215.99,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":366.78,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":142.64,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN PT 4.0X36 ","code_information":[{"code":"887548","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN PT 7X90 ","code_information":[{"code":"845572","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":663.43,"discounted_cash":663.43,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":59.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":152.59,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":530.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":610.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":398.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":497.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":175.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":298.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":116.10,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN SYNT 3.0X2 ","code_information":[{"code":"909553","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":561.07,"discounted_cash":561.07,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":145.88,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":50.50,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":129.05,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":280.54,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":448.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":516.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":336.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":476.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":476.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":420.80,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":280.54,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":476.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":280.54,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":148.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":252.48,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":98.19,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN THRD 3.0X11 ","code_information":[{"code":"909545","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":561.07,"discounted_cash":561.07,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":145.88,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":50.50,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":129.05,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":280.54,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":448.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":516.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":336.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":476.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":476.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":420.80,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":280.54,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":476.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":280.54,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":148.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":252.48,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":98.19,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN THRD 3.0X14 ","code_information":[{"code":"885130","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":898.54,"discounted_cash":898.54,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":233.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":80.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":206.66,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":449.27,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":718.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":826.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":539.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":763.76,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":763.76,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":673.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":449.27,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":763.76,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":449.27,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":238.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":404.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":157.24,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN THRD 3.0X34 ","code_information":[{"code":"909559","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":684.65,"discounted_cash":684.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":178.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":157.47,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":342.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":547.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":629.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":410.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":581.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":581.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":513.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":342.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":581.95,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":342.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":181.43,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":308.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.81,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN TI 7X85 32 ","code_information":[{"code":"824511","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":663.43,"discounted_cash":663.43,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":59.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":152.59,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":530.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":610.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":398.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":497.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":175.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":298.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":116.10,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANNULA SYNT 207.7 ","code_information":[{"code":"837855","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":675.10,"discounted_cash":675.10,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":175.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":60.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":155.27,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":337.55,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":540.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":621.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":405.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":573.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":573.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":506.32,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":337.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":573.84,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":337.55,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":178.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":303.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":118.14,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANNULA SYNT 207.7 ","code_information":[{"code":"837867","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":711.42,"discounted_cash":711.42,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":184.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":64.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":163.63,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":355.71,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":569.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":654.51,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":426.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":604.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":604.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":533.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":355.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":604.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":355.71,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":188.53,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":320.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":124.50,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW COR TI 2.7X12MM ","code_information":[{"code":"836650","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1182.79,"discounted_cash":1182.79,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":307.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":106.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":272.04,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":591.39,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":946.23,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1088.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":709.67,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1005.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1005.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":887.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":591.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1005.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":591.39,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":313.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":532.26,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":206.99,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 2.8MM 45MM ","code_information":[{"code":"526610","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.98,"discounted_cash":344.98,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":89.69,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":31.05,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":79.35,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":317.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":206.99,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":293.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":293.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":258.74,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":293.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":91.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":155.24,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":60.37,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 3.5X22 ","code_information":[{"code":"838026","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":71.08,"discounted_cash":71.08,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":18.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":16.35,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35.54,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":65.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":42.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":53.31,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35.54,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35.54,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":18.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":31.99,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":12.44,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 3.5X22.5 ","code_information":[{"code":"802235","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":644.17,"discounted_cash":644.17,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":167.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":57.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":148.16,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":322.08,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":515.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":592.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":386.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":547.54,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":547.54,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":483.13,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":322.08,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":547.54,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":322.08,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":170.71,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":289.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":112.73,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 3.5X40 ","code_information":[{"code":"837962","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":78.02,"discounted_cash":78.02,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":20.29,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":7.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.94,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.01,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":71.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":46.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":58.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.01,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.01,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":35.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.65,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 3.7X60MM ","code_information":[{"code":"847974","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 3.7X75MM ","code_information":[{"code":"847983","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":394.26,"discounted_cash":394.26,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":102.51,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":35.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":90.68,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":197.13,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":315.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":362.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":236.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":335.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":335.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":295.69,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":197.13,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":335.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":197.13,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":104.48,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":69.00,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 34XS4.5 LF ","code_information":[{"code":"971624","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":847.93,"discounted_cash":847.93,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":220.46,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":76.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":195.02,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":423.96,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":678.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":780.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":508.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":720.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":720.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":635.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":423.96,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":720.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":423.96,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":224.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":381.57,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":148.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 4.2X70MM ","code_information":[{"code":"847981","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 4.5X14 ","code_information":[{"code":"837697","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":105.20,"discounted_cash":105.20,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":27.35,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":9.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":24.20,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":84.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":96.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":63.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":78.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":27.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":47.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":18.41,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 4.5X20 ","code_information":[{"code":"837661","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":69.26,"discounted_cash":69.26,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":18.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.23,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":15.93,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":34.63,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":55.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":63.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":41.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":58.87,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":58.87,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":51.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":34.63,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":58.87,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":34.63,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":18.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":31.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":12.12,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 4.5X42 ","code_information":[{"code":"837711","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":105.20,"discounted_cash":105.20,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":27.35,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":9.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":24.20,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":84.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":96.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":63.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":78.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":27.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":47.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":18.41,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 4.5X46 ","code_information":[{"code":"837600","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":69.26,"discounted_cash":69.26,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":18.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.23,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":15.93,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":34.63,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":55.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":63.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":41.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":58.87,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":58.87,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":51.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":34.63,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":58.87,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":34.63,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":18.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":31.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":12.12,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT 4.5X46 ","code_information":[{"code":"837713","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":105.20,"discounted_cash":105.20,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":27.35,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":9.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":24.20,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":84.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":96.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":63.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":78.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":27.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":47.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":18.41,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT HEX 2.7X24 ","code_information":[{"code":"804432","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT HEX 3.2X12MM ","code_information":[{"code":"929240","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":314.65,"discounted_cash":314.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":81.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":28.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":72.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":157.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":251.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":289.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":188.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":267.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":267.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":235.99,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":157.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":267.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":157.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":83.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":141.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":55.06,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT HEX 3.5X40 ","code_information":[{"code":"880356","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT HEX 3.5X50 ","code_information":[{"code":"849192","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT LG HEX 4.5X30 ","code_information":[{"code":"883601","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":94.78,"discounted_cash":94.78,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":24.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":8.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":21.80,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":75.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":87.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":56.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":71.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":25.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":42.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":16.59,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT M/DN 4.2X25 ","code_information":[{"code":"883946","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT S/T 2.4X13MM ","code_information":[{"code":"930269","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":184.70,"discounted_cash":184.70,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":48.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":16.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":42.48,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":92.35,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":147.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":169.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":110.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":156.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":156.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":138.53,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":92.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":156.99,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":92.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":48.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":83.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":32.32,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT S/T 3.5X16MM ","code_information":[{"code":"875261","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT S/T 3.5X46MM ","code_information":[{"code":"875231","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":80.94,"discounted_cash":80.94,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":21.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":7.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":18.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":40.47,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":64.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":74.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":48.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":68.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":68.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":60.70,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":40.47,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":68.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":40.47,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":21.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":36.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":14.16,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT S/T 3.5X60MM ","code_information":[{"code":"875237","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":80.94,"discounted_cash":80.94,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":21.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":7.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":18.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":40.47,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":64.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":74.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":48.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":68.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":68.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":60.70,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":40.47,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":68.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":40.47,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":21.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":36.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":14.16,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT S/T 4.5X54MM ","code_information":[{"code":"846602","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":87.42,"discounted_cash":87.42,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":22.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":7.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":20.11,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43.71,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":69.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":80.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":52.45,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":65.56,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74.31,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43.71,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":23.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":39.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":15.30,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT S/T 4.5X62MM ","code_information":[{"code":"919114","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":87.42,"discounted_cash":87.42,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":22.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":7.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":20.11,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43.71,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":69.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":80.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":52.45,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":65.56,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74.31,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43.71,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":23.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":39.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":15.30,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT S/T 4.5X64MM ","code_information":[{"code":"919115","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":87.42,"discounted_cash":87.42,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":22.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":7.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":20.11,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43.71,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":69.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":80.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":52.45,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":65.56,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74.31,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43.71,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":23.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":39.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":15.30,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT SM 3.5X24 ","code_information":[{"code":"853847","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORT TT ST 1.5 X 6 ","code_information":[{"code":"836279","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":174.46,"discounted_cash":174.46,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":45.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":15.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":40.13,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":87.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":139.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":160.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":104.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":130.84,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":87.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":87.23,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":46.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":78.51,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":30.53,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORTEX 1.0X6 ","code_information":[{"code":"867015","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":242.47,"discounted_cash":242.47,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":63.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":21.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":55.77,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":121.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":193.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":223.07,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":145.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":206.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":206.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":181.85,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":121.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":206.10,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":121.23,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":64.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":109.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":42.43,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORTEX 1.5X6 ","code_information":[{"code":"813223","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":208.51,"discounted_cash":208.51,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":54.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":18.77,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":47.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":104.25,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":166.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":191.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":125.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":177.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":177.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":156.38,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":104.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":177.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":104.25,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":55.26,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":93.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":36.49,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORTEX 2.7X32 202. ","code_information":[{"code":"882605","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":151.07,"discounted_cash":151.07,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":39.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":13.60,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":34.75,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":75.53,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":120.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":138.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":90.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":128.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":128.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":113.30,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":75.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":128.41,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":75.53,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":40.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":67.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":26.44,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORTEX 2.7X36 202. ","code_information":[{"code":"882607","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.63,"discounted_cash":75.63,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.39,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.81,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.72,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.81,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.81,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.24,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORTEX 3.5X24 204. ","code_information":[{"code":"837953","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":78.02,"discounted_cash":78.02,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":20.29,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":7.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.94,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.01,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":71.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":46.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":58.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.01,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.01,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":35.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.65,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORTICAL 3.5X14 ","code_information":[{"code":"882221","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":181.97,"discounted_cash":181.97,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":47.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":16.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":41.85,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":145.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":167.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":109.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":136.48,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":48.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":81.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":31.84,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORTICAL 3.5X16 ","code_information":[{"code":"882223","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":181.97,"discounted_cash":181.97,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":47.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":16.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":41.85,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":145.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":167.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":109.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":136.48,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":48.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":81.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":31.84,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CORTICAL 3.5X18 ","code_information":[{"code":"882224","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":181.97,"discounted_cash":181.97,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":47.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":16.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":41.85,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":145.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":167.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":109.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":136.48,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":48.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":81.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":31.84,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CRNFCL ST 16X2MM ","code_information":[{"code":"971547","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":158.27,"discounted_cash":158.27,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":41.15,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":14.24,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":36.40,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.14,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":126.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":145.61,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":94.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":134.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":134.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":118.70,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":134.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.14,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":41.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":71.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":27.70,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CRUC PERIPH 5X55 ","code_information":[{"code":"826545","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":208.51,"discounted_cash":208.51,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":54.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":18.77,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":47.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":104.25,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":166.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":191.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":125.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":177.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":177.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":156.38,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":104.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":177.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":104.25,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":55.26,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":93.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":36.49,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW FT LCK 3.5X44 ","code_information":[{"code":"940284","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":527.75,"discounted_cash":527.75,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":137.22,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":47.50,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":121.38,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":263.88,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":422.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":485.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":316.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":448.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":448.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":395.81,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":263.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":448.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":263.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":139.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":237.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":92.36,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW GUIDE 33MM ","code_information":[{"code":"918843","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":555.98,"discounted_cash":555.98,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":28.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":132.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":45.03,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":132.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":79.51,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":144.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":50.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":127.88,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":45.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":63.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":45.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":26.13,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":71.72,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":115.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":71.72,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":45.59,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":277.99,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":102.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":123.43,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":444.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":511.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":333.59,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":472.58,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":155.67,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":155.67,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":150.11,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":105.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":472.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":416.99,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":72.28,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":277.99,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":472.58,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":277.99,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":147.33,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":250.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":97.30,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":555.98,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW INTRTN SBTCH 11X90 ","code_information":[{"code":"915366","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1042.53,"discounted_cash":1042.53,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":271.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":93.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":239.78,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":834.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":959.13,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":625.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":781.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":276.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":469.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":182.44,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW ISO FT CANC 4X60 ","code_information":[{"code":"974271","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":71.27,"discounted_cash":71.27,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":18.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":16.39,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35.63,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":57.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":65.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":42.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":53.45,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35.63,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60.58,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35.63,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":18.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":32.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":12.47,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LAG STD THRD 80M ","code_information":[{"code":"848278","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1042.53,"discounted_cash":1042.53,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":271.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":93.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":239.78,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":834.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":959.13,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":625.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":781.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":276.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":469.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":182.44,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK 2.7X28MM ","code_information":[{"code":"960525","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":411.21,"discounted_cash":411.21,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":106.91,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":37.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":94.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":205.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":328.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":378.31,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":246.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":349.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":349.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":308.41,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":205.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":349.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":205.60,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":108.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":185.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":71.96,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK 2.7X30MM ","code_information":[{"code":"960526","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":411.21,"discounted_cash":411.21,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":106.91,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":37.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":94.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":205.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":328.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":378.31,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":246.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":349.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":349.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":308.41,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":205.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":349.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":205.60,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":108.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":185.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":71.96,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK DRV 4X60MM ","code_information":[{"code":"929715","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":466.26,"discounted_cash":466.26,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":121.23,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":41.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":107.24,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":233.13,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":373.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":428.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":279.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":396.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":396.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":349.69,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":233.13,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":396.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":233.13,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":123.56,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":209.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":81.60,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK LOPRO 2.7X20 ","code_information":[{"code":"930703","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK ST 2.3X11 ","code_information":[{"code":"925654","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK THRD 04X28 ","code_information":[{"code":"804447","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":454.92,"discounted_cash":454.92,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":118.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":40.94,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":104.63,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":227.46,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":363.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":418.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":272.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":386.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":386.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":227.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":386.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":227.46,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":120.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":204.71,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK TI 3.5X65MM ","code_information":[{"code":"914184","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":473.88,"discounted_cash":473.88,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":123.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":42.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":108.99,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":236.94,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":379.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":435.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":284.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":402.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":402.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":355.41,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":236.94,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":402.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":236.94,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":125.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":213.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":82.93,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LOCK SS 3.5X38 ","code_information":[{"code":"898272","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LOCKING 3.5X30MM ","code_information":[{"code":"933752","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN LCK 7HL 125MM ","code_information":[{"code":"933614","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2240.56,"discounted_cash":2240.56,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":582.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":201.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":515.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1120.28,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1792.45,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2061.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1344.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1904.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1904.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1680.42,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1120.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1904.48,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1120.28,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":593.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1008.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":392.10,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN LCK POLY RIGHT ","code_information":[{"code":"995131","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7133.15,"discounted_cash":7133.15,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1854.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":641.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1640.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3566.57,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5706.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6562.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4279.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6063.18,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6063.18,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5349.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3566.57,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6063.18,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3566.57,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1890.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3209.92,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1248.30,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN MDSHFT 8H 97MM ","code_information":[{"code":"954895","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3412.81,"discounted_cash":3412.81,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":887.33,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":307.15,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":784.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1706.40,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2730.25,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3139.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2047.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2900.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2900.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2559.61,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1706.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2900.89,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1706.40,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":904.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1535.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":597.24,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN MED 4HL 1X2.3MM ","code_information":[{"code":"959200","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":764.11,"discounted_cash":764.11,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":198.67,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":68.77,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":175.75,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":382.06,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":611.29,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":702.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":458.47,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":649.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":649.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":573.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":382.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":649.49,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":382.06,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":202.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":343.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":133.72,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN MED 6HL 1X2.3MM ","code_information":[{"code":"959204","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1042.56,"discounted_cash":1042.56,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":271.07,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":93.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":239.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.28,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":834.05,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":959.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":625.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.18,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.18,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":781.92,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.18,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.28,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":276.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":469.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":182.45,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN MED 7HL 1X2.3MM ","code_information":[{"code":"959205","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1097.61,"discounted_cash":1097.61,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":285.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":98.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":252.45,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":548.80,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":878.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1009.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":658.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":932.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":932.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":823.21,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":548.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":932.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":548.80,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":290.87,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":493.92,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":192.08,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN NAR 5MM 259MM ","code_information":[{"code":"935139","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":799.75,"discounted_cash":799.75,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":207.94,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":71.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":183.94,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":399.88,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":639.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":735.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":479.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":679.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":679.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":599.81,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":399.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":679.79,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":399.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":211.93,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":359.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":139.96,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN NAR LT ","code_information":[{"code":"941443","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4610.80,"discounted_cash":4610.80,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1198.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":414.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1060.48,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2305.40,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3688.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4241.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2766.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3919.18,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3919.18,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3458.10,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2305.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3919.18,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2305.40,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1221.86,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2074.86,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":806.89,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN NAR PRFL 8HL ","code_information":[{"code":"930300","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3370.20,"discounted_cash":3370.20,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":876.25,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":303.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":775.15,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1685.10,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2696.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3100.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2022.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2864.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2864.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2527.65,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1685.10,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2864.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1685.10,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":893.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1516.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":589.78,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN RADIUS 6HL ","code_information":[{"code":"532093","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2580.72,"discounted_cash":2580.72,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":670.99,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":232.26,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":593.57,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1290.36,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2064.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2374.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1548.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2193.61,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2193.61,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1935.54,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1290.36,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2193.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1290.36,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":683.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1161.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":451.63,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN RT 2MM 76MM ","code_information":[{"code":"936477","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3130.91,"discounted_cash":3130.91,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":814.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":281.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":720.11,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1565.45,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2504.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2880.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1878.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2661.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2661.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2348.18,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1565.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2661.27,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1565.45,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":829.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1408.91,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":547.91,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN SM 10HL 1X1.7MM ","code_information":[{"code":"959163","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1633.01,"discounted_cash":1633.01,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":424.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":146.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":375.59,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":816.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1306.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1502.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":979.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1388.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1388.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1224.76,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":816.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1388.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":816.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":432.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":734.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":285.78,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN STD LT 3HL ","code_information":[{"code":"957240","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1705.95,"discounted_cash":1705.95,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":443.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":153.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":392.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1569.47,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1023.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":452.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":767.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":298.54,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN STD RT 24X51MM ","code_information":[{"code":"960379","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3032.80,"discounted_cash":3032.80,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":788.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":272.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":697.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2426.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2790.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1819.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2577.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2577.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2274.60,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2577.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":803.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":530.74,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN STERNUM PEEK ","code_information":[{"code":"516680","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2763.64,"discounted_cash":2763.64,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":718.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":248.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":635.64,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1381.82,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2210.91,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2542.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1658.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2349.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2349.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2072.73,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1381.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2349.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1381.82,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":732.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1243.64,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":483.64,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN TBLR 8HL 103MM ","code_information":[{"code":"875205","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":242.85,"discounted_cash":242.85,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":63.14,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":21.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":55.86,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":121.42,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":194.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":223.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":145.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":206.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":206.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":182.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":121.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":206.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":121.42,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":64.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":109.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":42.50,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN TBLR 8HL 95MM ","code_information":[{"code":"989708","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1031.15,"discounted_cash":1031.15,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":268.10,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":92.80,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":237.16,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":515.58,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":824.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":948.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":618.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":876.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":876.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":773.36,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":515.58,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":876.48,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":515.58,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":273.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":464.02,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":180.45,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN TBLR COLR 7HL ","code_information":[{"code":"875204","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":216.92,"discounted_cash":216.92,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":56.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":19.52,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":49.89,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":108.46,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":173.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":199.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":130.15,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":184.38,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":184.38,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":162.69,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":108.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":184.38,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":108.46,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":57.48,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":97.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":37.96,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN WIDE RT ","code_information":[{"code":"940464","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3032.80,"discounted_cash":3032.80,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":788.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":272.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":697.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2426.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2790.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1819.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2577.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2577.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2274.60,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2577.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":803.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":530.74,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE DHS 135DD L206 ","code_information":[{"code":"968687","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3252.75,"discounted_cash":3252.75,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":845.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":292.75,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":748.13,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1626.38,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2602.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2992.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1951.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2764.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2764.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2439.56,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1626.38,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2764.84,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1626.38,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":861.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1463.74,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":569.23,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE DHS 135DD L238 ","code_information":[{"code":"968688","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1709.74,"discounted_cash":1709.74,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":444.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":153.88,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":393.24,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":854.87,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1367.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1572.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1025.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1453.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1453.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1282.31,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":854.87,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1453.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":854.87,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":453.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":769.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":299.20,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE NAR L178MM LC- ","code_information":[{"code":"837484","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":722.87,"discounted_cash":722.87,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":187.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":65.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":166.26,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":361.44,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":578.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":665.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":433.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":614.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":614.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":542.15,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":361.44,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":614.44,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":361.44,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":191.56,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":325.29,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":126.50,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CLOVERLEAF 241.84 ","code_information":[{"code":"837397","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":524.79,"discounted_cash":524.79,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":136.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":47.23,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":120.70,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":262.39,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":419.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":482.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":314.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":446.07,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":446.07,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":393.59,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":262.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":446.07,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":262.39,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":139.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":236.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":91.84,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CNDRL 12H 204X3.5 ","code_information":[{"code":"837446","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2098.55,"discounted_cash":2098.55,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":545.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":188.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":482.67,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1049.28,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1678.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1930.67,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1259.13,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1783.77,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1783.77,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1573.91,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1049.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1783.77,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1049.28,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":556.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":944.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":367.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CNDRL 12H 95D240MM ","code_information":[{"code":"837444","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2098.55,"discounted_cash":2098.55,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":545.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":188.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":482.67,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1049.28,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1678.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1930.67,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1259.13,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1783.77,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1783.77,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1573.91,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1049.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1783.77,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1049.28,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":556.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":944.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":367.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CNDRL 5H 95 156X50 ","code_information":[{"code":"837024","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1929.77,"discounted_cash":1929.77,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":501.74,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":173.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":443.85,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":964.88,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1543.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1775.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1157.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1640.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1640.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1447.33,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":964.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1640.30,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":964.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":511.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":868.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":337.71,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CNDYL 4.5 8H/206-R ","code_information":[{"code":"875604","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5375.33,"discounted_cash":5375.33,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1397.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":483.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1236.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2687.66,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4300.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4945.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":3225.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4569.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4569.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":4031.50,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2687.66,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4569.03,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2687.66,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1424.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2418.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":940.68,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CNDYLR4.5 6H/170-L ","code_information":[{"code":"873636","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5273.43,"discounted_cash":5273.43,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1371.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":474.61,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1212.89,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2636.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4218.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4851.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":3164.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4482.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4482.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3955.07,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2636.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4482.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2636.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1397.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2373.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":922.85,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE DHS 150 DEGREE 6/1 ","code_information":[{"code":"837044","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1757.81,"discounted_cash":1757.81,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":457.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":158.20,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":404.30,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":878.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1406.25,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1617.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1054.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1494.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1494.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1318.36,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":878.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1494.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":878.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":465.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":791.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":307.62,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE DHS 95 DEGREE 6/11 ","code_information":[{"code":"837023","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3233.72,"discounted_cash":3233.72,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":840.77,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":291.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":743.76,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1616.86,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2586.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2975.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1940.23,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2748.66,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2748.66,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2425.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1616.86,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2748.66,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1616.86,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":856.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1455.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":565.90,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE DIST FEM 23MM ","code_information":[{"code":"916316","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4170.10,"discounted_cash":4170.10,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1084.23,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":375.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":959.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3336.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3836.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2502.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3544.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3544.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3127.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3544.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1105.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1876.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":729.77,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE FRAG DCP 25MM 2HL ","code_information":[{"code":"837383","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":519.37,"discounted_cash":519.37,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":135.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":46.74,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":119.46,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":259.69,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":415.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":477.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":311.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":441.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":441.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":389.53,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":259.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":441.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":259.69,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":137.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":233.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":90.89,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE HND WRST PRFL 5290 ","code_information":[{"code":"835457","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":964.85,"discounted_cash":964.85,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":250.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":86.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":221.92,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":482.43,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":771.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":887.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":578.91,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":820.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":820.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":723.64,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":482.43,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":820.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":482.43,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":255.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":434.18,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":168.85,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE L OBL 1.5X3HX4H LT ","code_information":[{"code":"814157","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":284.33,"discounted_cash":284.33,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":73.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":25.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":65.40,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":227.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":170.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":213.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":75.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":127.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":49.76,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE L OBL TT 2MM 2HX3H ","code_information":[{"code":"814162","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":284.33,"discounted_cash":284.33,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":73.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":25.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":65.40,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":227.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":170.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":213.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":75.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":127.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":49.76,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE LCDCP 8H/4.5 142 ","code_information":[{"code":"837482","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":547.72,"discounted_cash":547.72,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":142.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":49.29,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":125.98,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":273.86,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":438.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":503.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":328.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":465.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":465.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":410.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":273.86,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":465.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":273.86,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":145.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":246.47,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":95.85,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE LCK P-AX 4HL 60MM ","code_information":[{"code":"946568","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1990.28,"discounted_cash":1990.28,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":517.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":179.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":457.76,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1592.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1831.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1194.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1691.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1691.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1492.71,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1691.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":527.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":895.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":348.30,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE LCP 12-HOLEX141 ","code_information":[{"code":"803117","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":659.18,"discounted_cash":659.18,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":171.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":59.33,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":151.61,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":329.59,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":527.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":606.45,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":395.51,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":560.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":560.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":494.38,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":329.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":560.30,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":329.59,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":174.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":296.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":115.36,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE LCP 3.5MM 223.561 ","code_information":[{"code":"802922","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1101.82,"discounted_cash":1101.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":286.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":99.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":253.42,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":550.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":881.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1013.67,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":661.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":936.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":936.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":826.37,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":550.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":936.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":550.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":291.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":495.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":192.82,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE LCP 3.5MM 223.591 ","code_information":[{"code":"802924","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1133.51,"discounted_cash":1133.51,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":294.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":260.71,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":566.75,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":906.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1042.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":680.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":963.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":963.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":850.13,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":566.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":963.48,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":566.75,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":300.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":510.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":198.36,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE LCP PROXHUM 6H/5H ","code_information":[{"code":"873814","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7141.11,"discounted_cash":7141.11,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1856.69,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":642.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1642.46,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3570.55,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5712.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6569.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4284.67,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6069.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6069.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5355.83,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3570.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6069.94,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3570.55,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1892.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3213.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1249.69,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE MDFC RT .7MM 3X4HL ","code_information":[{"code":"944134","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1037.22,"discounted_cash":1037.22,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":269.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":93.35,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":238.56,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":518.61,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":829.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":954.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":622.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":881.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":881.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":777.91,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":518.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":881.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":518.61,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":274.86,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":466.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":181.51,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE MNDB 12HL 2.5MM ","code_information":[{"code":"949335","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3365.19,"discounted_cash":3365.19,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":874.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":302.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":773.99,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1682.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2692.15,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3095.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2019.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2860.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2860.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2523.89,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1682.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2860.41,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1682.60,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":891.78,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1514.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":588.91,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE NARROW 4.5X214 12H ","code_information":[{"code":"837486","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":417.01,"discounted_cash":417.01,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":108.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":37.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":95.91,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":208.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":333.61,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":383.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":250.21,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":354.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":354.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":312.76,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":208.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":354.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":208.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":110.51,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":187.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":72.98,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE ORT 36X2.7MM ","code_information":[{"code":"971555","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1171.87,"discounted_cash":1171.87,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":304.69,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":105.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":269.53,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":585.93,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":937.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1078.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":703.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":996.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":996.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":878.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":585.93,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":996.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":585.93,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":310.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":527.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":205.08,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE RT 67/10/1.2MM 3.5 ","code_information":[{"code":"837377","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":493.59,"discounted_cash":493.59,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":128.33,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":44.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":113.53,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":246.79,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":394.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":454.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":296.15,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":419.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":419.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":370.19,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":246.79,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":419.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":246.79,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":130.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":222.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":86.38,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SCR SS 54X2.4MM ","code_information":[{"code":"939770","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3931.53,"discounted_cash":3931.53,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1022.20,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":353.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":904.25,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1965.77,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3145.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3617.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2358.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3341.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3341.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2948.65,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1965.77,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3341.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1965.77,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1041.86,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1769.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":688.02,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SEMI-TUBULAR 5H X ","code_information":[{"code":"837502","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":204.71,"discounted_cash":204.71,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":53.22,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":18.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":47.08,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":163.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":188.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":122.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":174.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":174.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":153.53,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":174.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":54.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":92.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":35.82,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SEMI-TUBULAR 6H X ","code_information":[{"code":"837503","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":204.71,"discounted_cash":204.71,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":53.22,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":18.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":47.08,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":163.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":188.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":122.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":174.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":174.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":153.53,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":174.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":54.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":92.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":35.82,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SMTP-8 ","code_information":[{"code":"968549","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1956.16,"discounted_cash":1956.16,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":508.60,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":176.05,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":449.92,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":978.08,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1564.93,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1799.67,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1173.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1662.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1662.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1467.12,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":978.08,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1662.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":978.08,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":518.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":880.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":342.33,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SPN 16MM 1LVL ASMB ","code_information":[{"code":"960076","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3601.45,"discounted_cash":3601.45,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":936.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":324.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":828.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2881.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3313.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2160.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2701.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":954.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1620.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":630.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SPN 2 LVL 42MM ","code_information":[{"code":"510891","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3601.45,"discounted_cash":3601.45,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":936.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":324.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":828.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2881.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3313.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2160.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2701.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":954.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1620.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":630.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SPN 23MM ","code_information":[{"code":"940775","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3601.45,"discounted_cash":3601.45,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":936.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":324.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":828.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2881.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3313.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2160.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2701.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":954.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1620.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":630.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SPN 40MM ","code_information":[{"code":"967734","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3601.45,"discounted_cash":3601.45,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":936.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":324.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":828.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2881.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3313.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2160.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2701.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":954.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1620.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":630.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SPN 58MM 10MM ","code_information":[{"code":"874962","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1326.85,"discounted_cash":1326.85,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":344.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":305.18,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1061.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1220.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":796.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":351.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":597.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":232.20,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SPN 6MM ","code_information":[{"code":"518957","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3601.45,"discounted_cash":3601.45,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":936.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":324.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":828.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2881.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3313.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2160.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2701.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":954.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1620.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":630.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SPN 8MM ","code_information":[{"code":"517005","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3601.45,"discounted_cash":3601.45,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":936.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":324.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":828.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2881.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3313.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2160.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2701.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":954.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1620.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":630.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SPN 9MM ","code_information":[{"code":"517187","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3601.45,"discounted_cash":3601.45,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":936.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":324.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":828.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2881.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3313.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2160.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2701.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":954.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1620.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":630.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SPN CER L2 34MM ","code_information":[{"code":"939598","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3601.45,"discounted_cash":3601.45,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":936.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":324.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":828.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2881.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3313.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2160.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2701.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":954.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1620.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":630.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SPN CERV 48MM 3LVL ","code_information":[{"code":"991559","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3601.45,"discounted_cash":3601.45,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":936.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":324.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":828.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2881.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3313.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2160.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2701.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3061.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1800.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":954.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1620.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":630.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SPN VSA 8H/145DG ","code_information":[{"code":"968037","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1611.18,"discounted_cash":1611.18,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":418.91,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":370.57,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1288.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1482.29,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1369.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1369.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1208.38,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1369.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":426.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":725.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":281.96,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SS 6 HL LCK BN LT ","code_information":[{"code":"940182","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2748.48,"discounted_cash":2748.48,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":714.60,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":247.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":632.15,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1374.24,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2198.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2528.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1649.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2336.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2336.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2061.36,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1374.24,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2336.21,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1374.24,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":728.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1236.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":480.98,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE STD CRV 96X34X3.7 ","code_information":[{"code":"937994","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4264.88,"discounted_cash":4264.88,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1108.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":383.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":980.92,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2132.44,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3411.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3923.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2558.93,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3625.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3625.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3198.66,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2132.44,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3625.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2132.44,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1130.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1919.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":746.35,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE STD DHS 140 281.24 ","code_information":[{"code":"837025","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1757.81,"discounted_cash":1757.81,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":457.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":158.20,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":404.30,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":878.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1406.25,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1617.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1054.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1494.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1494.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1318.36,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":878.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1494.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":878.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":465.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":791.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":307.62,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE STD DHS 140 281.26 ","code_information":[{"code":"837028","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1755.23,"discounted_cash":1755.23,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":456.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":157.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":403.70,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":877.62,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1404.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1614.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1053.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1491.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1491.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1316.42,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":877.62,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1491.95,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":877.62,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":465.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":789.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":307.17,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE STD DHS 145 281.35 ","code_information":[{"code":"837032","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1755.23,"discounted_cash":1755.23,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":456.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":157.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":403.70,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":877.62,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1404.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1614.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1053.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1491.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1491.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1316.42,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":877.62,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1491.95,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":877.62,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":465.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":789.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":307.17,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SUPR DECRSD 7HL LT ","code_information":[{"code":"971535","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3070.86,"discounted_cash":3070.86,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":798.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":276.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":706.30,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1535.43,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2456.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2825.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1842.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2610.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2610.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2303.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1535.43,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2610.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1535.43,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":813.78,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1381.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":537.40,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SYNTH DCP 2.7 5H ","code_information":[{"code":"968031","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1364.76,"discounted_cash":1364.76,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":354.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":122.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":313.89,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":682.38,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1091.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1255.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":818.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1160.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1160.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1023.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":682.38,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1160.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":682.38,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":361.66,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":614.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":238.83,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE SZ 2 MTP-RS2L ","code_information":[{"code":"967724","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4587.11,"discounted_cash":4587.11,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1192.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":412.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1055.04,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2293.55,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3669.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4220.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2752.27,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3899.04,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3899.04,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3440.33,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2293.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3899.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2293.55,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1215.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2064.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":802.74,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE T 148MM SS 4.5MM ","code_information":[{"code":"837442","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1008.41,"discounted_cash":1008.41,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":262.19,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":90.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":231.93,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":504.20,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":806.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":927.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":605.05,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":857.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":857.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":756.31,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":504.20,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":857.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":504.20,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":267.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":453.78,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":176.47,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE TI 6 HL LCK BN STR ","code_information":[{"code":"935431","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2700.97,"discounted_cash":2700.97,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":702.25,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":243.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":621.22,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1350.48,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2160.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2484.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1620.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2295.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2295.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2025.73,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1350.48,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2295.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1350.48,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":715.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1215.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":472.67,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE TIB BN 4 HL LOCK ","code_information":[{"code":"901506","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4170.10,"discounted_cash":4170.10,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1084.23,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":375.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":959.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3336.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3836.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2502.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3544.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3544.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3127.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3544.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1105.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1876.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":729.77,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE TIT TSRH .625 ","code_information":[{"code":"818210","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2274.60,"discounted_cash":2274.60,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":591.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":204.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1137.30,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1819.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2092.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1933.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1933.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1705.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1137.30,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1933.41,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1137.30,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":602.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1023.57,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":398.06,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE TRI ANKLE HOOKR-4 ","code_information":[{"code":"968039","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2653.70,"discounted_cash":2653.70,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":689.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":238.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":610.35,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1326.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2122.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2441.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1592.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2255.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2255.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1990.28,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1326.85,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2255.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1326.85,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":703.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1194.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":464.40,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE TRMA 10HL FMRL CVD ","code_information":[{"code":"934841","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3688.64,"discounted_cash":3688.64,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":959.05,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":331.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":848.39,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1844.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2950.91,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3393.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2213.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3135.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3135.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2766.48,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1844.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3135.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1844.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":977.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1659.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":645.51,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE VOLAR 4 PEG LT 3H ","code_information":[{"code":"968670","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2653.70,"discounted_cash":2653.70,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":689.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":238.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":610.35,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1326.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2122.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2441.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1592.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2255.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2255.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1990.28,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1326.85,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2255.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1326.85,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":703.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1194.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":464.40,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE W/CBL LG 210MM ","code_information":[{"code":"906324","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4637.34,"discounted_cash":4637.34,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1205.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":417.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1066.59,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2318.67,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3709.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4266.35,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2782.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3941.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3941.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3478.01,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2318.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3941.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2318.67,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1228.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2086.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":811.53,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE ZIM TIB14 HLE10-14 ","code_information":[{"code":"969788","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4170.10,"discounted_cash":4170.10,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1084.23,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":375.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":959.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3336.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3836.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2502.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3544.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3544.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3127.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3544.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1105.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1876.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":729.77,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE ZYGONATIC 2.0 5H ","code_information":[{"code":"813242","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":864.35,"discounted_cash":864.35,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":224.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":77.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":198.80,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":691.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":795.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":518.61,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":648.26,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":734.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.18,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":229.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":388.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":151.26,"methodology":"percent of total billed charges"}]}]},{"description":"PLC ST LOC DVC 1ST LES ","code_information":[{"code":"716569","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7904.93,"discounted_cash":7904.93,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":403.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":640.30,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":371.53,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3952.47,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1454.51,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":1754.89,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6323.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7272.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4742.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6719.19,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":513.82,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2134.33,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1501.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6719.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5928.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":513.82,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":513.82,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":513.82,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3952.47,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6719.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3952.47,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3557.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1383.36,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":7904.93,"methodology":"percent of total billed charges"}]}]},{"description":"PLT ORT TI MINI 57X7.0LT ","code_information":[{"code":"905444","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1182.79,"discounted_cash":1182.79,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":307.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":106.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":272.04,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":591.39,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":946.23,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1088.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":709.67,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1005.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1005.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":887.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":591.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1005.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":591.39,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":313.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":532.26,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":206.99,"methodology":"percent of total billed charges"}]}]},{"description":"PLTS PHERESIS EACH UNIT ","code_information":[{"code":"686553","type":"CDM"},{"code":"P9034","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":752.10,"discounted_cash":752.10,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":38.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":179.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":179.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":107.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":195.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":67.69,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":172.98,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":61.67,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":86.49,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":61.67,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":97.02,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":156.44,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":97.02,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":61.67,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":376.05,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":138.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":166.97,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":601.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":691.93,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":451.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":639.28,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":48.89,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":210.59,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":210.59,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":203.07,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":142.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":639.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":564.08,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":48.89,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":48.89,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":48.89,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":97.77,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":376.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":639.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":376.05,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":199.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":338.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":131.62,"methodology":"percent of total billed charges"}]}]},{"description":"PLUG CABLE SS 5MM ","code_information":[{"code":"901826","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":226.63,"discounted_cash":226.63,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":18.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":58.92,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":20.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":52.12,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":10.65,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":181.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":208.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":135.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":192.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":192.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":169.97,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":192.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":60.06,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":101.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":39.66,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":226.63,"methodology":"percent of total billed charges"}]}]},{"description":"PLUG DEFIB RCPTCL DF-1 A ","code_information":[{"code":"971440","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":79.61,"discounted_cash":79.61,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":6.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":20.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":7.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":18.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":3.74,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.80,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":63.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":73.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":47.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":67.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":67.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":59.71,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":67.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.80,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":21.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":35.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.93,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"}]}]},{"description":"PLUG SURG 1.55X1.3IN ","code_information":[{"code":"834529","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":528.09,"discounted_cash":528.09,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":137.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":47.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":121.46,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":264.05,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":422.47,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":485.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":316.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":448.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":448.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":396.07,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":264.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":448.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":264.05,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":139.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":237.64,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":92.42,"methodology":"percent of total billed charges"}]}]},{"description":"PORT IMP INFSN ISP 8.0FR ","code_information":[{"code":"814881","type":"CDM"},{"code":"C1788","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":625.52,"discounted_cash":625.52,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":162.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":56.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":143.87,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":312.76,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":500.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":575.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":375.31,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":531.69,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":531.69,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":469.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":312.76,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":531.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":312.76,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":165.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":281.48,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":109.47,"methodology":"percent of total billed charges"}]}]},{"description":"PORT IMPL INFSN 8.0FR ","code_information":[{"code":"958414","type":"CDM"},{"code":"C1788","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1042.53,"discounted_cash":1042.53,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":271.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":93.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":239.78,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":834.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":959.13,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":625.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":781.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":276.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":469.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":182.44,"methodology":"percent of total billed charges"}]}]},{"description":"PORT IMPL INFSN 9.6FR ","code_information":[{"code":"907906","type":"CDM"},{"code":"C1788","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1308.08,"discounted_cash":1308.08,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":340.10,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":117.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":300.86,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":654.04,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1046.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1203.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":784.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1111.87,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1111.87,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":981.06,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":654.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1111.87,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":654.04,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":346.64,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":588.64,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":228.91,"methodology":"percent of total billed charges"}]}]},{"description":"PORT IMPL INFSN TI 8.0FR ","code_information":[{"code":"896981","type":"CDM"},{"code":"C1788","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7460.69,"discounted_cash":7460.69,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1939.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":671.46,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1715.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3730.34,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5968.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6863.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4476.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6341.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6341.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5595.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3730.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6341.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3730.34,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1977.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3357.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1305.62,"methodology":"percent of total billed charges"}]}]},{"description":"PORT INFS 9.6FR 66CM ","code_information":[{"code":"504650","type":"CDM"},{"code":"C1788","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":985.66,"discounted_cash":985.66,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":256.27,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":88.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":226.70,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":492.83,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":788.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":906.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":591.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":837.81,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":837.81,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":739.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":492.83,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":837.81,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":492.83,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":261.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":443.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"}]}]},{"description":"POST BN MED 30D 4MM 16MM ","code_information":[{"code":"998979","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4617.44,"discounted_cash":4617.44,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1200.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":415.57,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1062.01,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2308.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3693.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4248.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2770.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3924.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3924.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3463.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2308.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3924.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2308.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1223.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2077.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":808.05,"methodology":"percent of total billed charges"}]}]},{"description":"POST EX FIX 11MM ","code_information":[{"code":"952609","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":46.06,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":81.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":46.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":65.39,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":46.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":26.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":73.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":118.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":73.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":46.63,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":104.63,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":126.24,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.96,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":159.22,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":159.22,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":153.54,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":108.04,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.96,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.96,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.96,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":73.92,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"}]}]},{"description":"POT BIC/CA 20MEQ TAB ","code_information":[{"code":"718161","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4.34,"discounted_cash":4.34,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.22,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":1.03,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":0.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":1.03,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":0.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":0.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":0.50,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.20,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":0.56,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":0.90,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":0.56,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.36,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2.17,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":0.96,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3.47,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3.99,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3.69,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.28,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1.22,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1.22,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1.17,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":0.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3.69,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3.25,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.28,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.28,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.28,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":0.56,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2.17,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2.17,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":0.76,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":4.34,"methodology":"percent of total billed charges"}]}]},{"description":"POT CHL SA 10MEQ TAB ","code_information":[{"code":"684892","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":10.17,"discounted_cash":10.17,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.52,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":2.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":0.82,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":2.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":1.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":0.92,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2.34,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":1.17,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":2.12,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.83,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5.08,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":2.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":9.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.64,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.66,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1.93,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":7.63,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.66,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.66,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.66,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":1.32,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5.08,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5.08,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1.78,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":10.17,"methodology":"percent of total billed charges"}]}]},{"description":"POTASS CL10 MEQ INJ ","drug_information":{"unit":"10","type":"ME"},"code_information":[{"code":"703505","type":"CDM"},{"code":"J3480","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24.00,"discounted_cash":24.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":6.24,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":5.52,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.97,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":2.76,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.97,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":3.10,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":4.99,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":3.10,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.97,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":12.00,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":22.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":14.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":18.00,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":12.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":12.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":6.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":4.20,"methodology":"percent of total billed charges"}]}]},{"description":"POTASSIUM UR ","code_information":[{"code":"686103","type":"CDM"},{"code":"84133","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":6.59,"discounted_cash":6.59,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.34,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":0.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1.52,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3.29,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5.27,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":3.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5.60,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.43,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1.85,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1.85,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1.78,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":4.94,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.43,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.43,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.43,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3.29,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1.15,"methodology":"percent of total billed charges"}]}]},{"description":"POUCH OST 2.25IN 12IN ","code_information":[{"code":"916235","type":"CDM"},{"code":"A5063","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2.28,"discounted_cash":2.28,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":0.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":0.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":0.33,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":0.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":0.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":0.52,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1.14,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1.71,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1.94,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1.14,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":0.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":0.40,"methodology":"percent of total billed charges"}]}]},{"description":"POUCH TISSUE 10X8 LAP SA ","code_information":[{"code":"906956","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":829.63,"discounted_cash":829.63,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":42.31,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":197.45,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":67.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":197.45,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":118.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":215.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":74.67,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":190.81,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":68.03,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":95.41,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":68.03,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":38.99,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":107.02,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":172.56,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":107.02,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":68.03,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":414.81,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":152.65,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":184.18,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":663.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":763.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":497.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":705.19,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":53.93,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":232.30,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":232.30,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":224.00,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":157.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":705.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":622.22,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":53.93,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":53.93,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":53.93,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":107.85,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":414.81,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":705.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":414.81,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":219.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":373.33,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":145.19,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":829.63,"methodology":"percent of total billed charges"}]}]},{"description":"POV IODINE 5% OP ","code_information":[{"code":"676312","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":13.57,"discounted_cash":13.57,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.69,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":3.23,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":3.23,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":1.94,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1.22,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3.12,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.11,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":1.56,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.11,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":2.82,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.11,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6.79,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":2.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":3.01,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":12.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":8.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11.53,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.88,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":3.66,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":2.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":10.18,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.88,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.88,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.88,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":1.76,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6.79,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6.79,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2.37,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":13.57,"methodology":"percent of total billed charges"}]}]},{"description":"PPSV23 VAC IMSQ ","drug_information":{"unit":"0.5","type":"ML"},"code_information":[{"code":"678378","type":"CDM"},{"code":"90732","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":531.00,"discounted_cash":531.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":138.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":47.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":122.13,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":43.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":61.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":43.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":68.50,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":110.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":68.50,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":43.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":265.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":424.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":488.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":318.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":451.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":451.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":398.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":265.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":451.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":265.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":140.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":238.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":92.92,"methodology":"percent of total billed charges"}]}]},{"description":"PPSV23 VAC IMSQ ","drug_information":{"unit":"0.5","type":"ML"},"code_information":[{"code":"687229","type":"CDM"},{"code":"90732","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":531.00,"discounted_cash":531.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":138.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":47.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":122.13,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":43.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":61.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":43.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":68.50,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":110.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":68.50,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":43.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":265.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":424.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":488.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":318.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":451.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":451.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":398.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":265.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":451.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":265.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":140.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":238.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":92.92,"methodology":"percent of total billed charges"}]}]},{"description":"PRAMOX/HYDROC 1/1% TOP ","code_information":[{"code":"698392","type":"CDM"},{"code":"S5000","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":67.00,"discounted_cash":67.00,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":5.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":17.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":15.41,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.49,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":7.71,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.49,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":3.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":8.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":13.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":8.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.49,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":33.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":53.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":61.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":40.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":56.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":56.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":50.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":33.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":56.95,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":33.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":17.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":30.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":11.72,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":67.00,"methodology":"percent of total billed charges"}]}]},{"description":"PRAZOSIN 5 MG PO ","code_information":[{"code":"720717","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7.07,"discounted_cash":7.07,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":1.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":0.57,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":1.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":1.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":0.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":0.81,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.33,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":0.91,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":1.47,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":0.91,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3.54,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":1.57,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6.01,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.46,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1.98,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1.98,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1.91,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6.01,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5.30,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.46,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.46,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.46,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":0.92,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3.54,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6.01,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3.54,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1.87,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3.18,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1.24,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":7.07,"methodology":"percent of total billed charges"}]}]},{"description":"PRBC ","code_information":[{"code":"686558","type":"CDM"},{"code":"P9021","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":708.55,"discounted_cash":708.55,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":36.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":168.63,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":168.63,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":101.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":184.22,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":63.77,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":162.97,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":58.10,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":81.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":58.10,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":91.40,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":147.38,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":91.40,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":58.10,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":354.27,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":130.37,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":157.30,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":566.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":651.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":425.13,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":602.27,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":46.06,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":198.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":198.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":191.31,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":134.62,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":602.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":531.41,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":46.06,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":46.06,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":46.06,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":92.11,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":354.27,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":602.27,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":354.27,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":187.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":318.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":124.00,"methodology":"percent of total billed charges"}]}]},{"description":"PRBC WASH ","code_information":[{"code":"686567","type":"CDM"},{"code":"P9022","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":865.10,"discounted_cash":865.10,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":44.12,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":205.89,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":205.89,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":123.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":224.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":77.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":198.97,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":70.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":99.49,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":70.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":111.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":179.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":111.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":70.94,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.55,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":159.18,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":192.05,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":692.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":795.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":519.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":735.34,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":56.23,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":242.23,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":242.23,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":233.58,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":164.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":735.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":648.83,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":56.23,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":56.23,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":56.23,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":112.46,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":735.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":432.55,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":229.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":389.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":151.39,"methodology":"percent of total billed charges"}]}]},{"description":"PRBE US TRIPLNE TRANSRCT ","code_information":[{"code":"502506","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"PRC D-E COR REVSC CHRN S ","code_information":[{"code":"705882","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":78042.58,"discounted_cash":78042.58,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":3980.17,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":6321.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":3668.00,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39021.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":14359.83,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":17325.45,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62434.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":71799.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":46825.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66336.19,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":5072.77,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":21071.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":14828.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66336.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":58531.93,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":5072.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":5072.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":5072.77,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39021.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66336.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39021.29,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":35119.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13657.45,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":78042.58,"methodology":"percent of total billed charges"}]}]},{"description":"PREDNISOLON 15MG/5ML LIQ ","drug_information":{"unit":"15","type":"ME"},"code_information":[{"code":"708529","type":"CDM"},{"code":"J7510","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":33.00,"discounted_cash":33.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":1.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":8.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":7.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":2.71,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":3.79,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":2.71,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":4.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":6.86,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":4.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":2.71,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":16.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":6.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":7.33,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":30.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":19.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":28.05,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.15,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":9.24,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":9.24,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":8.91,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":6.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":28.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":24.75,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.15,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.15,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.15,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":4.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":16.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":28.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":16.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":8.74,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":5.78,"methodology":"percent of total billed charges"}]}]},{"description":"PRISMASOLBGK2/3.5 5000ML ","code_information":[{"code":"707428","type":"CDM"},{"code":"J3490","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":541.00,"discounted_cash":541.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":140.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":48.69,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":124.43,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":44.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":62.22,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":44.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":69.79,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":112.53,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":69.79,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":44.36,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":270.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":432.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":497.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":324.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":459.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":459.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":405.75,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":270.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":459.85,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":270.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":143.37,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":243.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":94.67,"methodology":"percent of total billed charges"}]}]},{"description":"PROBE ABL PREC 20CM 15GA ","code_information":[{"code":"984406","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":8312.71,"discounted_cash":8312.71,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":423.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":1978.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":673.33,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":1978.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":1188.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2161.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":748.14,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1911.92,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":681.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":955.96,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":681.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":390.70,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1072.34,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":1729.04,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1072.34,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":681.64,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4156.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1529.54,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":1845.42,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6650.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7647.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4987.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7065.80,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":540.33,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":2327.56,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":2327.56,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2244.43,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1579.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7065.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":6234.53,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":540.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":540.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":540.33,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":1080.65,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4156.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7065.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4156.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2202.87,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3740.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1454.72,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":8312.71,"methodology":"percent of total billed charges"}]}]},{"description":"PROBE ENDO 160CM 1.8MM ","code_information":[{"code":"968074","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"PROBE TIP INCRMT NS 1MM ","code_information":[{"code":"979720","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"PROCHLORPERAZ 10 MG INJ ","drug_information":{"unit":"10","type":"ME"},"code_information":[{"code":"702593","type":"CDM"},{"code":"J0780","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":51.00,"discounted_cash":51.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":13.26,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":4.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":11.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":5.87,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":6.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":10.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":6.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.18,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":25.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":46.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":30.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":43.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":43.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":38.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":25.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":43.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":25.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":13.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":8.93,"methodology":"percent of total billed charges"}]}]},{"description":"PROLACTIN ","code_information":[{"code":"684597","type":"CDM"},{"code":"84146","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":834.90,"discounted_cash":834.90,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":42.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":217.07,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":75.14,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":192.03,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":417.45,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":667.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":768.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":500.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":709.66,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":54.27,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":233.77,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":233.77,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":225.42,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":158.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":709.66,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":626.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":54.27,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":54.27,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":54.27,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":417.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":709.66,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":417.45,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":221.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":375.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":146.11,"methodology":"percent of total billed charges"}]}]},{"description":"PROMETHAZINE 12.5MG SUPP ","code_information":[{"code":"698538","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":17.00,"discounted_cash":17.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":4.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1.38,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":4.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":2.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3.91,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.39,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":1.96,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.39,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":2.19,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":3.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":2.19,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.39,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":3.13,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":3.77,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":15.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":10.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14.45,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":4.59,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":3.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":12.75,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":2.21,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2.98,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":17.00,"methodology":"percent of total billed charges"}]}]},{"description":"PROMETHAZINE 25 MG SUPP ","code_information":[{"code":"698540","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":19.22,"discounted_cash":19.22,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.98,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":4.57,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1.56,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":4.57,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":5.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":4.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":2.21,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.90,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":2.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":4.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":2.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9.61,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":3.54,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":4.27,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":17.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":11.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16.34,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.25,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":5.19,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":3.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":14.41,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.25,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.25,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.25,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":2.50,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9.61,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":5.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3.36,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":19.22,"methodology":"percent of total billed charges"}]}]},{"description":"PROPRANOLOL 20MG TAB ","code_information":[{"code":"698614","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":10.17,"discounted_cash":10.17,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.52,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":2.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":0.82,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":2.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":1.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":0.92,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2.34,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":1.17,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":2.12,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.83,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5.08,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":2.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":9.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.64,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.66,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1.93,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":7.63,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.66,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.66,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.66,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":1.32,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5.08,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5.08,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1.78,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":10.17,"methodology":"percent of total billed charges"}]}]},{"description":"PROST TRAINING EA 15M PT ","code_information":[{"code":"712470","type":"CDM"},{"code":"97761","type":"CPT"}],"standard_charges":[{"modifiers":"GP","modifiers_description":"Services delivered under an outpatient physical therapy plan of care","setting":"outpatient","gross_charge":550.04,"discounted_cash":550.04,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":28.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":130.91,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":130.91,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":78.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":143.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":49.50,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":126.51,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":275.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":101.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":122.11,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":440.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":506.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":330.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":467.53,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":35.75,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":154.01,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":154.01,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":148.51,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":104.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":467.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":412.53,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":35.75,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":35.75,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":35.75,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":71.51,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":275.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":467.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":275.02,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":145.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":247.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":96.26,"methodology":"percent of total billed charges"}]}]},{"description":"PROSTH PENL 16CM 12.5MM ","code_information":[{"code":"849621","type":"CDM"},{"code":"C1813","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28433.11,"discounted_cash":28433.11,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":7392.61,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2558.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":6539.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":14216.56,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22746.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":26158.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":17059.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24168.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24168.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":21324.83,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":14216.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24168.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":14216.56,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":7534.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12794.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":4975.79,"methodology":"percent of total billed charges"}]}]},{"description":"PROSTH PENL PUMP PS 21CM ","code_information":[{"code":"901253","type":"CDM"},{"code":"C1813","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28433.11,"discounted_cash":28433.11,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":7392.61,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2558.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":6539.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":14216.56,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22746.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":26158.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":17059.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24168.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24168.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":21324.83,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":14216.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24168.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":14216.56,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":7534.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12794.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":4975.79,"methodology":"percent of total billed charges"}]}]},{"description":"PSA PEROX AB ","code_information":[{"code":"684613","type":"CDM"},{"code":"88342","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":701.80,"discounted_cash":701.80,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":35.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":182.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":63.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":161.41,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":561.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":645.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":421.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":189.49,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":133.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":91.23,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":185.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":315.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":122.81,"methodology":"percent of total billed charges"}]}]},{"description":"PSEUDOEPHEDRINE 30MG TAB ","code_information":[{"code":"698677","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":0.09,"discounted_cash":0.09,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":0.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":0.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":0.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":0.02,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":0.02,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":0.04,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":0.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":0.02,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":0.07,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":0.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":0.05,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":0.08,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":0.02,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":0.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":0.08,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":0.07,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":0.01,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":0.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":0.08,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":0.04,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":0.02,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":0.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":0.02,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":0.09,"methodology":"percent of total billed charges"}]}]},{"description":"PSMA PEROX AB ","code_information":[{"code":"710262","type":"CDM"},{"code":"88342","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":701.80,"discounted_cash":701.80,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":35.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":182.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":63.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":161.41,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":561.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":645.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":421.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":189.49,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":133.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":91.23,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":185.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":315.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":122.81,"methodology":"percent of total billed charges"}]}]},{"description":"PTCA EA ADDL BRANCH ","code_information":[{"code":"705848","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":56365.43,"discounted_cash":56365.43,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":2874.64,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":4565.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":2649.18,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":28182.72,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":10371.24,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":12513.13,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":45092.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":51856.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":33819.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":47910.62,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3663.75,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":15218.67,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":10709.43,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":47910.62,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":42274.07,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3663.75,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3663.75,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3663.75,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":28182.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":47910.62,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":28182.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":25364.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":9863.95,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":56365.43,"methodology":"percent of total billed charges"}]}]},{"description":"PUMP PAIN 400MLX4ML/HR ","code_information":[{"code":"903851","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1883.12,"discounted_cash":1883.12,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":96.04,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":448.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":152.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":448.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":269.29,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":489.61,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":169.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":433.12,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":154.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":216.56,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":154.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":88.51,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":242.92,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":391.69,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":242.92,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":154.42,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":941.56,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":346.49,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":418.05,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1506.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1732.47,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1129.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1600.65,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":122.40,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":527.27,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":527.27,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":508.44,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":357.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1600.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1412.34,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":122.40,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":122.40,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":122.40,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":244.81,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":941.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1600.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":941.56,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":499.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":847.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":329.55,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1883.12,"methodology":"percent of total billed charges"}]}]},{"description":"PUNCH 2.5MM SHRT HNDL ST ","code_information":[{"code":"501941","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":186.28,"discounted_cash":186.28,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":9.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":44.33,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":15.09,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":44.33,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":26.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":48.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":16.77,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":42.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":15.27,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":21.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":15.27,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":8.76,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":24.03,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":38.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":24.03,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":15.27,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":93.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":34.28,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":41.35,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":149.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":171.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":111.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":158.34,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":12.11,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":52.16,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":52.16,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":50.30,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":35.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":158.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":139.71,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":12.11,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":12.11,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":12.11,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":24.22,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":93.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":158.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":93.14,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":49.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":83.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":32.60,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":186.28,"methodology":"percent of total billed charges"}]}]},{"description":"PURAPLY 8SQCM ","drug_information":{"unit":"8","type":"EA"},"code_information":[{"code":"974993","type":"CDM"},{"code":"Q4195","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3396.74,"discounted_cash":3396.74,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":883.15,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":305.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":781.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":278.53,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":390.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":278.53,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":438.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":706.52,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":438.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":278.53,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1698.37,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2717.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3125.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2038.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2887.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2887.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2547.55,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1698.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2887.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1698.37,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":900.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1528.53,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":594.43,"methodology":"percent of total billed charges"}]}]},{"description":"PURAPLY AM 8SQCM ","drug_information":{"unit":"8","type":"EA"},"code_information":[{"code":"974951","type":"CDM"},{"code":"Q4196","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3396.74,"discounted_cash":3396.74,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":883.15,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":305.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":781.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":278.53,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":390.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":278.53,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":438.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":706.52,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":438.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":278.53,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1698.37,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2717.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3125.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2038.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2887.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2887.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2547.55,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1698.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2887.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1698.37,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":900.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1528.53,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":594.43,"methodology":"percent of total billed charges"}]}]},{"description":"RANITIDINE 15MG/ML 120ML ","code_information":[{"code":"698771","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":120.96,"discounted_cash":120.96,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":6.17,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":28.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":9.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":28.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":17.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":31.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":10.89,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":27.82,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":9.92,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":13.91,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":9.92,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":5.69,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":15.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":25.16,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":15.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":9.92,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":60.48,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":22.26,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":26.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":96.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":111.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":72.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":102.82,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.86,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":32.66,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":22.98,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":102.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":90.72,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.86,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.86,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.86,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":15.72,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":60.48,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":102.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":60.48,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":32.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":54.43,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":21.17,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":120.96,"methodology":"percent of total billed charges"}]}]},{"description":"RANOLAZINE 500 MG TAB ","code_information":[{"code":"688685","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":70.09,"discounted_cash":70.09,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":3.57,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":16.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":5.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":16.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":10.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":18.22,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":16.12,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":8.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":3.29,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":9.04,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":14.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":9.04,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.75,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35.05,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":12.90,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":15.56,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56.07,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":64.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":42.05,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":59.58,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.56,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":18.92,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":13.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":59.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":52.57,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.56,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.56,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.56,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":9.11,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":59.58,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35.05,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":18.57,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":31.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":12.27,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":70.09,"methodology":"percent of total billed charges"}]}]},{"description":"RASBURICASE 0.5 MG INJJW ","drug_information":{"unit":"0.5","type":"ME"},"code_information":[{"code":"717429","type":"CDM"},{"code":"J2783","type":"HCPCS"}],"standard_charges":[{"modifiers":"JW","modifiers_description":"Drug amount discarded/not administered to any patient","setting":"outpatient","gross_charge":971.00,"discounted_cash":971.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":252.46,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":87.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":223.33,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":79.62,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":111.67,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":79.62,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":125.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":201.97,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":125.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":79.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":485.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":776.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":893.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":582.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":825.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":825.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":728.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":485.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":825.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":485.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":257.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":436.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":169.93,"methodology":"percent of total billed charges"}]}]},{"description":"RASBURICASE 7.5 MG INJ ","drug_information":{"unit":"7.5","type":"ME"},"code_information":[{"code":"691785","type":"CDM"},{"code":"J2783","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14564.00,"discounted_cash":14564.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3786.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1310.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3349.72,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1194.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":1674.86,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1194.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1878.76,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":3029.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1878.76,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1194.25,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7282.00,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11651.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":13398.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":8738.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12379.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12379.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":10923.00,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7282.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12379.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7282.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3859.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6553.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2548.70,"methodology":"percent of total billed charges"}]}]},{"description":"RASP SURG DISP 12MM ","code_information":[{"code":"988130","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1414.02,"discounted_cash":1414.02,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":72.12,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":336.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":114.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":336.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":202.20,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":367.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":127.26,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":325.22,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":115.95,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":162.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":115.95,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":66.46,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":182.41,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":294.12,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":182.41,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":115.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":707.01,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":260.18,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":313.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1131.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1300.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":848.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1201.92,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":91.91,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":395.93,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":395.93,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":381.79,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":268.66,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1201.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1060.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":91.91,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":91.91,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":91.91,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":183.82,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":707.01,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1201.92,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":707.01,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":374.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":636.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":247.45,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1414.02,"methodology":"percent of total billed charges"}]}]},{"description":"RE-EVALUATION OT ","code_information":[{"code":"717348","type":"CDM"},{"code":"97168","type":"CPT"}],"standard_charges":[{"modifiers":"GO","modifiers_description":"Services delivered under an outpatient occupational therapy plan of care","setting":"outpatient","gross_charge":597.56,"discounted_cash":597.56,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":30.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":155.37,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":53.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":137.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":298.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":109.95,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":132.66,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":478.05,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":549.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":358.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":507.93,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":38.84,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":167.32,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":167.32,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":161.34,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":113.54,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":507.93,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":448.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":38.84,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":38.84,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":38.84,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":77.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":298.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":507.93,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":298.78,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":158.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":268.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":104.57,"methodology":"percent of total billed charges"}]}]},{"description":"RE-EVALUATION OT ","code_information":[{"code":"717349","type":"CDM"},{"code":"97168","type":"CPT"}],"standard_charges":[{"modifiers":"GO","modifiers_description":"Services delivered under an outpatient occupational therapy plan of care","setting":"outpatient","gross_charge":597.56,"discounted_cash":597.56,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":30.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":155.37,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":53.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":137.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":298.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":109.95,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":132.66,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":478.05,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":549.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":358.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":507.93,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":38.84,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":167.32,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":167.32,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":161.34,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":113.54,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":507.93,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":448.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":38.84,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":38.84,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":38.84,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":77.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":298.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":507.93,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":298.78,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":158.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":268.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":104.57,"methodology":"percent of total billed charges"}]}]},{"description":"REAMER 240X8 BIXCUT DISP ","code_information":[{"code":"909374","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"REAMER CAN 16.5MM ","code_information":[{"code":"969033","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1048.75,"discounted_cash":1048.75,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":53.49,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":249.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":84.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":249.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":149.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":272.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":94.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":241.21,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":86.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":120.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":86.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":49.29,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":135.29,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":218.14,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":135.29,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":86.00,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":524.38,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":192.97,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":232.82,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":839.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":964.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":629.25,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":891.44,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.17,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":293.65,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":293.65,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":283.16,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":199.26,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":891.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":786.56,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.17,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":136.34,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":524.38,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":891.44,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":524.38,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":277.92,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":471.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":183.53,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1048.75,"methodology":"percent of total billed charges"}]}]},{"description":"REAMER SURG 9MM ACRN ORT ","code_information":[{"code":"923885","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"RECOMBIVAX PED 5MCG IM ","code_information":[{"code":"720877","type":"CDM"},{"code":"90744","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":179.00,"discounted_cash":179.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":46.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":16.11,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":41.17,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.68,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":20.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.68,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":23.09,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":37.23,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":23.09,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.68,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":89.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":143.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":164.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":107.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":152.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":152.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":134.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":89.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":152.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":89.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":47.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":80.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":31.32,"methodology":"percent of total billed charges"}]}]},{"description":"REDUCER CAP 5MM 1SEAL ","code_information":[{"code":"832535","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":37.53,"discounted_cash":37.53,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":1.91,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":8.93,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":3.04,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":8.93,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":5.37,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":9.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":3.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":8.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.08,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":4.32,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.08,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1.76,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":4.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":7.81,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":4.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.08,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":18.77,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":6.91,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":8.33,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":34.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":22.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31.90,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.44,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":10.51,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":10.51,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":10.13,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":7.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":28.15,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.44,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.44,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.44,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":4.88,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":18.77,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":18.77,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":9.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":6.57,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":37.53,"methodology":"percent of total billed charges"}]}]},{"description":"RELOAD STPLR 1.5X40MM ","code_information":[{"code":"512973","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":605.35,"discounted_cash":605.35,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":49.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":157.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":54.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":139.23,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":28.45,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":302.68,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":484.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":556.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":363.21,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":514.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":514.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":454.01,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":302.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":514.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":302.68,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":160.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":272.41,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":105.94,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":605.35,"methodology":"percent of total billed charges"}]}]},{"description":"RELOAD STPLR 2X45MM ","code_information":[{"code":"809039","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1030.01,"discounted_cash":1030.01,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":83.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":267.80,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":92.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":236.90,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":48.41,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":515.00,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":824.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":947.61,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":618.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":875.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":875.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":772.51,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":515.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":875.51,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":515.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":272.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":463.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":180.25,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1030.01,"methodology":"percent of total billed charges"}]}]},{"description":"RELOAD STPLR 30MM ","code_information":[{"code":"831056","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":122.60,"discounted_cash":122.60,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":9.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":31.88,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":11.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":28.20,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":5.76,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":61.30,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":98.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":112.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":73.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":104.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":104.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":91.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":61.30,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":104.21,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":61.30,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":32.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":55.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":21.45,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":122.60,"methodology":"percent of total billed charges"}]}]},{"description":"RELOAD STPLR 30MM ","code_information":[{"code":"937908","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":884.67,"discounted_cash":884.67,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":71.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":230.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":79.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":203.47,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":41.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":442.33,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":707.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":813.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":530.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":751.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":751.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":663.50,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":442.33,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":751.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":442.33,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":234.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":398.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":154.82,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":884.67,"methodology":"percent of total billed charges"}]}]},{"description":"RELOAD STPLR 45MM ","code_information":[{"code":"826399","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":355.18,"discounted_cash":355.18,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":28.77,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":92.35,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":31.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":81.69,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":16.69,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":177.59,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":284.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":326.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":213.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":301.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":301.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":266.38,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":177.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":301.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":177.59,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":94.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":159.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":62.16,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":355.18,"methodology":"percent of total billed charges"}]}]},{"description":"RELOAD STPLR 45MM ","code_information":[{"code":"986895","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1011.06,"discounted_cash":1011.06,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":81.90,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":262.88,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":91.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":232.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":47.52,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":505.53,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":808.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":930.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":606.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":859.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":859.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":758.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":505.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":859.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":505.53,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":267.93,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":454.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":176.94,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1011.06,"methodology":"percent of total billed charges"}]}]},{"description":"RELOAD STPLR 45MM ","code_information":[{"code":"989349","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":468.49,"discounted_cash":468.49,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":37.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":121.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":42.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":107.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":22.02,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.25,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":374.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":431.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":281.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":398.22,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":398.22,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":351.37,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":398.22,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.25,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":124.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":210.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":81.99,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":468.49,"methodology":"percent of total billed charges"}]}]},{"description":"RELOAD STPLR 4MM ","code_information":[{"code":"866381","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":136.63,"discounted_cash":136.63,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":11.07,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":35.52,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":12.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":31.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":6.42,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":68.31,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":109.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":125.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":81.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":116.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":116.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":102.47,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":68.31,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":116.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":68.31,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":36.21,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":61.48,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":23.91,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":136.63,"methodology":"percent of total billed charges"}]}]},{"description":"RELOAD STPLR 55MM ","code_information":[{"code":"832502","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":150.46,"discounted_cash":150.46,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":12.19,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":39.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":13.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":34.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":7.07,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":75.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":120.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":138.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":90.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":127.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":127.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":112.84,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":75.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":127.89,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":75.23,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":39.87,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":67.71,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":26.33,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":150.46,"methodology":"percent of total billed charges"}]}]},{"description":"RELOAD STPLR 60MM ","code_information":[{"code":"973038","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":519.25,"discounted_cash":519.25,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":42.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":135.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":46.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":119.43,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":24.40,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":259.63,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":415.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":477.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":311.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":441.36,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":441.36,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":389.44,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":259.63,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":441.36,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":259.63,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":137.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":233.66,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":90.87,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":519.25,"methodology":"percent of total billed charges"}]}]},{"description":"RELOAD STPLR 75MM ","code_information":[{"code":"832438","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":206.38,"discounted_cash":206.38,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":16.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":53.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":18.57,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":47.47,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":9.70,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":103.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":165.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":189.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":123.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":175.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":175.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":154.78,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":103.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":175.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":103.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":54.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":92.87,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":36.12,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":206.38,"methodology":"percent of total billed charges"}]}]},{"description":"REM DEVITLIZD TISS NS OT ","code_information":[{"code":"712461","type":"CDM"},{"code":"97602","type":"CPT"}],"standard_charges":[{"modifiers":"GO","modifiers_description":"Services delivered under an outpatient occupational therapy plan of care","setting":"outpatient","gross_charge":656.96,"discounted_cash":656.96,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":33.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":156.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":156.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":93.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":170.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":59.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":151.10,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":328.48,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":120.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":145.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":525.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":604.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":394.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":558.42,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":183.95,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":183.95,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":177.38,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":124.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":558.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":492.72,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":85.40,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":328.48,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":558.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":328.48,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":174.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":295.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":114.97,"methodology":"percent of total billed charges"}]}]},{"description":"REM DEVTLZD TISS NS OTCO ","code_information":[{"code":"718950","type":"CDM"},{"code":"97602","type":"CPT"}],"standard_charges":[{"modifiers":"GO|CO","modifiers_description":"Services delivered under an outpatient occupational therapy plan of care|Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant","setting":"outpatient","gross_charge":656.96,"discounted_cash":656.96,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":33.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":156.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":156.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":93.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":170.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":59.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":151.10,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":328.48,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":120.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":145.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":525.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":604.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":394.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":558.42,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":183.95,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":183.95,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":177.38,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":124.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":558.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":492.72,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":85.40,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":328.48,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":558.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":328.48,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":174.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":295.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":114.97,"methodology":"percent of total billed charges"}]}]},{"description":"REM DEVTLZD TISS NS PTCQ ","code_information":[{"code":"719217","type":"CDM"},{"code":"97602","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","gross_charge":656.96,"discounted_cash":656.96,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":33.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":156.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":156.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":93.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":170.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":59.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":151.10,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":328.48,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":120.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":145.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":525.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":604.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":394.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":558.42,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":183.95,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":183.95,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":177.38,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":124.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":558.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":492.72,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.70,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":85.40,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":328.48,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":558.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":328.48,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":174.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":295.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":114.97,"methodology":"percent of total billed charges"}]}]},{"description":"RENIN ","code_information":[{"code":"686175","type":"CDM"},{"code":"84244","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":10.45,"discounted_cash":10.45,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":0.94,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2.40,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5.22,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":9.61,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6.27,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.88,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.68,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":2.93,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":2.93,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2.82,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":7.84,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.68,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.68,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5.22,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5.22,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1.83,"methodology":"percent of total billed charges"}]}]},{"description":"RESTRICTOR CEMENT 10.5MM ","code_information":[{"code":"822284","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":208.51,"discounted_cash":208.51,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":54.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":18.77,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":47.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":104.25,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":166.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":191.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":125.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":177.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":177.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":156.38,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":104.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":177.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":104.25,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":55.26,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":93.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":36.49,"methodology":"percent of total billed charges"}]}]},{"description":"RETACRIT BS 3000U ESRD ","drug_information":{"unit":"3000","type":"UN"},"code_information":[{"code":"718455","type":"CDM"},{"code":"Q5105","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":254.00,"discounted_cash":254.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":66.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":22.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":58.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":20.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":29.21,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":20.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":32.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":52.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":32.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":20.83,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":127.00,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":203.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":233.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":152.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":215.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":215.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":190.50,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":127.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":215.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":127.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":67.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":114.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":44.45,"methodology":"percent of total billed charges"}]}]},{"description":"RETRACTOR ATRL LFT SYS 3 ","code_information":[{"code":"986874","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1579.08,"discounted_cash":1579.08,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":80.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":375.82,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":127.91,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":375.82,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":225.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":410.56,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":142.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":363.19,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":129.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":181.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":129.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":74.22,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":203.70,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":328.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":203.70,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":129.48,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":789.54,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":290.55,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":350.56,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1263.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1452.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":947.45,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1342.22,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":102.64,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":442.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":442.14,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":426.35,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":300.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1342.22,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1184.31,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":102.64,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":102.64,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":102.64,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":205.28,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":789.54,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1342.22,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":789.54,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":418.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":710.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":276.34,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1579.08,"methodology":"percent of total billed charges"}]}]},{"description":"RETRCTR WND LG 9-14CM ","code_information":[{"code":"875585","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":804.19,"discounted_cash":804.19,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":41.01,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":191.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":65.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":191.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":115.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":209.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":72.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":184.96,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":65.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":92.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":65.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":37.80,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":103.74,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":167.27,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":103.74,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":65.94,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":402.10,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":147.97,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":178.53,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":643.35,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":739.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":482.51,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":683.56,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":52.27,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":225.17,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":225.17,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":217.13,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":152.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":683.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":603.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":52.27,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":52.27,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":52.27,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":104.54,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":402.10,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":683.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":402.10,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":213.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":361.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":140.73,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":804.19,"methodology":"percent of total billed charges"}]}]},{"description":"RETRCTR WND XSM 2-4CM ","code_information":[{"code":"979912","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":741.46,"discounted_cash":741.46,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":37.81,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":176.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":60.06,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":176.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":106.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":192.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":66.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":170.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":60.80,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":85.27,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":60.80,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":34.85,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":95.65,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":154.22,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":95.65,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":60.80,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":370.73,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":136.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":164.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":593.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":682.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":444.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":630.24,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":48.19,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":207.61,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":207.61,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":200.19,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":140.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":630.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":556.10,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":48.19,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":48.19,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":48.19,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":96.39,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":370.73,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":630.24,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":370.73,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":196.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":333.66,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":129.76,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":741.46,"methodology":"percent of total billed charges"}]}]},{"description":"RETRIEVER SUTURE 10.1IN ","code_information":[{"code":"977252","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":231.56,"discounted_cash":231.56,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":11.81,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":55.11,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":18.76,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":55.11,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":33.11,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":60.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":20.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":53.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":18.99,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":26.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":18.99,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":10.88,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":29.87,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":48.16,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":29.87,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":18.99,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":115.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":42.61,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":51.41,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":185.25,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":213.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":138.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":196.83,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":15.05,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":64.84,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":64.84,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":62.52,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":44.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":196.83,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":173.67,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":15.05,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":15.05,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":15.05,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":30.10,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":115.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":196.83,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":115.78,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":61.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":104.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":40.52,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":231.56,"methodology":"percent of total billed charges"}]}]},{"description":"RETRVL IVC FILTER W IMAG ","code_information":[{"code":"705531","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":49704.38,"discounted_cash":49704.38,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":2534.92,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":4026.05,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":2336.11,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":24852.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":9145.61,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":11034.37,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39763.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":45728.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":29822.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":42248.72,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3230.78,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":13420.18,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":9443.83,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":42248.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":37278.29,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3230.78,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3230.78,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3230.78,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":24852.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":42248.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":24852.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22366.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":8698.27,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":49704.38,"methodology":"percent of total billed charges"}]}]},{"description":"REVAS TIB STNT/ANG EA AD ","code_information":[{"code":"704925","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":70897.53,"discounted_cash":70897.53,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":3615.77,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":5742.70,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":3332.18,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35448.76,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":13045.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":15739.25,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56718.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":65225.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":42538.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60262.90,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4608.34,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":19142.33,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":13470.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60262.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":53173.15,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4608.34,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4608.34,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4608.34,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35448.76,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60262.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":35448.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":31903.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":12407.07,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":70897.53,"methodology":"percent of total billed charges"}]}]},{"description":"REVAS TIBPER/TLA EA ADD ","code_information":[{"code":"704923","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":42555.70,"discounted_cash":42555.70,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":2170.34,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":3447.01,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":2000.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":21277.85,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":7830.25,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":9447.37,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34044.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":39151.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":25533.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":36172.34,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2766.12,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":11490.04,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":8085.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":36172.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":31916.78,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2766.12,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2766.12,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2766.12,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":21277.85,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":36172.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":21277.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":19150.06,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":7447.25,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":42555.70,"methodology":"percent of total billed charges"}]}]},{"description":"RHIG HUMN MINIDOSE 50MCG ","drug_information":{"unit":"50","type":"GM"},"code_information":[{"code":"689360","type":"CDM"},{"code":"J2788","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":643.00,"discounted_cash":643.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":167.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":57.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":147.89,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":52.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":73.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":52.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":82.95,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":133.74,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":82.95,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":52.73,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":321.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":514.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":591.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":385.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":546.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":546.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":482.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":321.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":546.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":321.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":170.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":289.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":112.53,"methodology":"percent of total billed charges"}]}]},{"description":"RIBOSOMAL P AB QL IA ","code_information":[{"code":"705442","type":"CDM"},{"code":"83516","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":408.31,"discounted_cash":408.31,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":20.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":106.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":36.75,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":93.91,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":204.16,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":326.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":375.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":244.99,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":347.06,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":26.54,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":114.33,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":114.33,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":110.24,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":77.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":347.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":306.23,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":26.54,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":26.54,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":26.54,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":204.16,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":347.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":204.16,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":108.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":183.74,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":71.45,"methodology":"percent of total billed charges"}]}]},{"description":"RIG KEDRAB 150 U IMSQ ","drug_information":{"unit":"150","type":"UN"},"code_information":[{"code":"720694","type":"CDM"},{"code":"90377","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":1118.43,"discounted_cash":1118.43,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":290.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":100.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":257.24,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":91.71,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":128.62,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":91.71,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":144.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":232.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":144.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":91.71,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":559.22,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":894.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1028.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":671.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":950.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":950.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":838.82,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":559.22,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":950.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":559.22,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":296.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":503.29,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":195.73,"methodology":"percent of total billed charges"}]}]},{"description":"RIG KEDRAB 300 U IMSQ ","drug_information":{"unit":"300","type":"UN"},"code_information":[{"code":"720708","type":"CDM"},{"code":"90377","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":2236.86,"discounted_cash":2236.86,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":581.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":201.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":514.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":183.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":257.24,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":183.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":288.55,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":465.27,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":288.55,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":183.42,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.43,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1789.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2057.91,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1342.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.33,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.33,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1677.64,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.43,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.33,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.43,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":592.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1006.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":391.45,"methodology":"percent of total billed charges"}]}]},{"description":"RING ANLPLS 32MM ","code_information":[{"code":"929269","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7861.59,"discounted_cash":7861.59,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":636.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2044.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":707.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1808.17,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":369.49,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3930.80,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6289.27,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7232.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4716.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6682.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6682.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5896.19,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3930.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6682.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3930.80,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2083.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3537.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1375.78,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":7861.59,"methodology":"percent of total billed charges"}]}]},{"description":"RING ANLPLS MTRL ET 34MM ","code_information":[{"code":"900682","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":8207.52,"discounted_cash":8207.52,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":664.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2133.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":738.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1887.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":385.75,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4103.76,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6566.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7550.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4924.51,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6976.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6976.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":6155.64,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4103.76,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6976.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4103.76,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2174.99,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3693.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1436.32,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":8207.52,"methodology":"percent of total billed charges"}]}]},{"description":"RING ANLPLS PRFL 30MM ","code_information":[{"code":"989979","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7108.13,"discounted_cash":7108.13,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":575.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1848.11,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":639.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1634.87,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":334.08,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3554.07,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5686.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6539.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4264.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6041.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6041.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5331.10,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3554.07,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6041.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3554.07,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1883.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3198.66,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1243.92,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":7108.13,"methodology":"percent of total billed charges"}]}]},{"description":"RING ANULPSTY MITRL 34MM ","code_information":[{"code":"508744","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7861.59,"discounted_cash":7861.59,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":636.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2044.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":707.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1808.17,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":369.49,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3930.80,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6289.27,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7232.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4716.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6682.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6682.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5896.19,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3930.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6682.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3930.80,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2083.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3537.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1375.78,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":7861.59,"methodology":"percent of total billed charges"}]}]},{"description":"RING ANULPSTY MITRL 38MM ","code_information":[{"code":"508746","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7861.59,"discounted_cash":7861.59,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":636.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2044.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":707.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1808.17,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":369.49,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3930.80,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6289.27,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7232.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4716.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6682.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6682.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5896.19,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3930.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6682.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3930.80,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2083.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3537.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1375.78,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":7861.59,"methodology":"percent of total billed charges"}]}]},{"description":"RING TRICUS CLASSIC 32MM ","code_information":[{"code":"859040","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7278.72,"discounted_cash":7278.72,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":589.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1892.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":655.08,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1674.11,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":342.10,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3639.36,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5822.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6696.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4367.23,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6186.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6186.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5459.04,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3639.36,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6186.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3639.36,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1928.86,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3275.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1273.78,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":7278.72,"methodology":"percent of total billed charges"}]}]},{"description":"RING TRICUSPID 26MM ","code_information":[{"code":"814339","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":6634.25,"discounted_cash":6634.25,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":537.37,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1724.90,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":597.08,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1525.88,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":311.81,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3317.13,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5307.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6103.51,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":3980.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5639.11,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5639.11,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":4975.69,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3317.13,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5639.11,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3317.13,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1758.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2985.41,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1160.99,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":6634.25,"methodology":"percent of total billed charges"}]}]},{"description":"RISPER CONSTA 12.5MG INJ ","drug_information":{"unit":"12.5","type":"ME"},"code_information":[{"code":"691788","type":"CDM"},{"code":"J2794","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2109.00,"discounted_cash":2109.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":548.34,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":189.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":485.07,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":172.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":242.53,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":172.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":272.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":438.67,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":272.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":172.94,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1054.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1687.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1940.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1265.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1792.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1792.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1581.75,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1054.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1792.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1054.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":558.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":949.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":369.07,"methodology":"percent of total billed charges"}]}]},{"description":"RISPERIDONE 0.25MG TAB ","code_information":[{"code":"698830","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":67.83,"discounted_cash":67.83,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":3.46,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":16.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":5.49,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":16.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":9.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":17.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.10,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":15.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.56,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":7.80,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.56,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":3.19,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":8.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":14.11,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":8.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.56,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":33.91,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":12.48,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":15.06,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":54.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":62.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":40.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":57.66,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.41,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":18.31,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":12.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":57.66,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":50.87,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.41,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.41,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.41,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":8.82,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":33.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":57.66,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":33.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":17.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":30.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":11.87,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":67.83,"methodology":"percent of total billed charges"}]}]},{"description":"RIVASTIGMINE 1.5MG CAP ","code_information":[{"code":"703550","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":67.83,"discounted_cash":67.83,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":3.46,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":16.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":5.49,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":16.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":9.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":17.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.10,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":15.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.56,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":7.80,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.56,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":3.19,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":8.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":14.11,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":8.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.56,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":33.91,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":12.48,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":15.06,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":54.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":62.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":40.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":57.66,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.41,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":18.31,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":12.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":57.66,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":50.87,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.41,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.41,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.41,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":8.82,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":33.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":57.66,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":33.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":17.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":30.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":11.87,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":67.83,"methodology":"percent of total billed charges"}]}]},{"description":"ROBOT OR LVL5 ADDT 30MIN ","code_information":[{"code":"694399","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":20770.86,"discounted_cash":20770.86,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":1059.31,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1682.44,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":976.23,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":10385.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":3821.84,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":4611.13,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16616.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":19109.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":12462.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17655.23,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1350.11,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":5608.13,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":3946.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17655.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":15578.15,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1350.11,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1350.11,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1350.11,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":10385.43,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17655.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":10385.43,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9346.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3634.90,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":20770.86,"methodology":"percent of total billed charges"}]}]},{"description":"ROD 5.5 STRAIGHT 130 ","code_information":[{"code":"929215","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1326.85,"discounted_cash":1326.85,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":344.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":305.18,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1061.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1220.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":796.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":351.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":597.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":232.20,"methodology":"percent of total billed charges"}]}]},{"description":"ROD 5.5MM STRAIGHT 40MM ","code_information":[{"code":"947244","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1326.85,"discounted_cash":1326.85,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":344.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":305.18,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1061.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1220.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":796.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":351.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":597.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":232.20,"methodology":"percent of total billed charges"}]}]},{"description":"ROD ALOY PRECON 5.5X40MM ","code_information":[{"code":"966485","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD CONN EXFX 100X11MM ","code_information":[{"code":"956394","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1290.68,"discounted_cash":1290.68,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":65.82,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":307.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":104.55,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":307.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":184.57,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":335.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":116.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":296.86,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":105.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":148.43,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":105.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":166.50,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":268.46,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":166.50,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":105.84,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":645.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":237.49,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":286.53,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1032.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1187.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":774.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1097.08,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":83.89,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":361.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":361.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":348.48,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":245.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1097.08,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":968.01,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":83.89,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":83.89,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":83.89,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":167.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":645.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1097.08,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":645.34,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":342.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":580.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":225.87,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1290.68,"methodology":"percent of total billed charges"}]}]},{"description":"ROD CONNECTOR XIA 0D LG ","code_information":[{"code":"933339","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1705.95,"discounted_cash":1705.95,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":443.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":153.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":392.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1569.47,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1023.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":452.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":767.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":298.54,"methodology":"percent of total billed charges"}]}]},{"description":"ROD EX FIX 11MM 250MM ","code_information":[{"code":"836739","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1384.69,"discounted_cash":1384.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":70.62,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":329.56,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":112.16,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":329.56,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":198.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":360.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":124.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":318.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":113.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":159.24,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":113.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":65.08,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":178.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":288.02,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":178.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":113.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":692.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":254.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":307.40,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1107.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1273.91,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":830.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1176.99,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":90.00,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":387.71,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":387.71,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":373.87,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":263.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1176.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1038.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":90.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":90.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":90.00,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":180.01,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":692.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1176.99,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":692.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":366.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":623.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":242.32,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1384.69,"methodology":"percent of total billed charges"}]}]},{"description":"ROD HUMERAL 8X260MM POL ","code_information":[{"code":"874845","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6634.25,"discounted_cash":6634.25,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1724.90,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":597.08,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1525.88,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3317.13,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5307.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6103.51,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":3980.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5639.11,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5639.11,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":4975.69,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3317.13,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5639.11,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3317.13,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1758.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2985.41,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1160.99,"methodology":"percent of total billed charges"}]}]},{"description":"ROD MIS STR 5.5MM ","code_information":[{"code":"510798","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SEXTANT 30MM TI SPIN ","code_information":[{"code":"894325","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1415.94,"discounted_cash":1415.94,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":368.14,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":127.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":325.67,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":707.97,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1132.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1302.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":849.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1203.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1203.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1061.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":707.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1203.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":707.97,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":375.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":637.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":247.79,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN 110MMX4.75MM ","code_information":[{"code":"955138","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN 5.5MM 110MM ","code_information":[{"code":"992560","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN 5.5MM 65MM ","code_information":[{"code":"913004","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN 5.5MM 70MM ","code_information":[{"code":"913003","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN 5.5X50 STRAIGHT ","code_information":[{"code":"903348","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN CONN ADJ 40MM ","code_information":[{"code":"986062","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1705.95,"discounted_cash":1705.95,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":443.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":153.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":392.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1569.47,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1023.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":452.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":767.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":298.54,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN OASYS TI 80X3.5 ","code_information":[{"code":"894529","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN PREBNT 50MM ","code_information":[{"code":"967479","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1095.60,"discounted_cash":1095.60,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":284.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":98.60,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":251.99,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":547.80,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":876.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1007.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":657.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":931.26,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":931.26,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":821.70,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":547.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":931.26,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":547.80,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":290.33,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":493.02,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":191.73,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN SOLERA 4.75 60MM ","code_information":[{"code":"948895","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN SXTNT 40X4.75MM ","code_information":[{"code":"947247","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1781.62,"discounted_cash":1781.62,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":463.22,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":160.35,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":409.77,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":890.81,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1425.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1639.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1068.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1514.38,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1514.38,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1336.21,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":890.81,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1514.38,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":890.81,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":472.13,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":801.73,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":311.78,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN TI 3X30MM ","code_information":[{"code":"931735","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPN TI 5.5X110 ","code_information":[{"code":"904330","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPNL 10CM 5.5MM ","code_information":[{"code":"933678","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPNL 300MM 5.5MM ","code_information":[{"code":"504068","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPNL 35MM 4.75MM ","code_information":[{"code":"947246","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1415.94,"discounted_cash":1415.94,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":368.14,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":127.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":325.67,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":707.97,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1132.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1302.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":849.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1203.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1203.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1061.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":707.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1203.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":707.97,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":375.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":637.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":247.79,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPNL 60MM LNGT ","code_information":[{"code":"944659","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1326.85,"discounted_cash":1326.85,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":344.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":305.18,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1061.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1220.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":796.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":351.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":597.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":232.20,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPNL 60MM5.5MM ","code_information":[{"code":"983043","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD SPNL TI 5.5X80MM PB ","code_information":[{"code":"896415","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1326.85,"discounted_cash":1326.85,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":344.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":305.18,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1061.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1220.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":796.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1127.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":351.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":597.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":232.20,"methodology":"percent of total billed charges"}]}]},{"description":"ROD TI ALLY CNTRD 5.5X50 ","code_information":[{"code":"969152","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROD TI ALY PCNTR 5.5X100 ","code_information":[{"code":"972790","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.38,"discounted_cash":682.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":156.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":180.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"}]}]},{"description":"ROM EA EXTRNK EX HN PTCQ ","code_information":[{"code":"719154","type":"CDM"},{"code":"95851","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","gross_charge":203.15,"discounted_cash":203.15,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":10.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":48.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":48.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":29.05,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":52.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":18.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":46.72,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":101.58,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":37.38,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":45.10,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":162.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":186.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":121.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":172.68,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":13.20,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":56.88,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":56.88,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":54.85,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":38.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":172.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":152.36,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":13.20,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":13.20,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":13.20,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":26.41,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":101.58,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":172.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":101.58,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":53.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":91.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":35.55,"methodology":"percent of total billed charges"}]}]},{"description":"ROPIVACAINE 200 MG INJ ","drug_information":{"unit":"200","type":"ME"},"code_information":[{"code":"691685","type":"CDM"},{"code":"J2795","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":357.00,"discounted_cash":357.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":92.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":32.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":82.11,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":29.27,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":41.05,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":29.27,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":46.05,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":74.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":46.05,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":29.27,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":178.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":285.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":328.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":214.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":303.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":303.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":267.75,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":178.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":303.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":178.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":94.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":160.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":62.48,"methodology":"percent of total billed charges"}]}]},{"description":"RTRCTR DASH 3 4IN 11IN ","code_information":[{"code":"968567","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":307.30,"discounted_cash":307.30,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":15.67,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":73.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":24.89,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":73.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":43.94,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":79.90,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":27.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":70.68,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":25.20,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":35.34,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":25.20,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":14.44,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":39.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":63.92,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":39.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":25.20,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":153.65,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":56.54,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":68.22,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":245.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":282.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":184.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":261.20,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":19.97,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":86.04,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":86.04,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":82.97,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":58.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":261.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":230.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":19.97,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":19.97,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":19.97,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":39.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":153.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":261.20,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":153.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":81.43,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":138.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":53.78,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":307.30,"methodology":"percent of total billed charges"}]}]},{"description":"RUSSELL VIPER DILUTED ","code_information":[{"code":"686213","type":"CDM"},{"code":"85613","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":517.32,"discounted_cash":517.32,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":26.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":134.50,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":46.56,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":118.98,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":258.66,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":413.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":475.93,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":310.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":439.72,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":33.63,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":144.85,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":144.85,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":139.68,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":98.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":439.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":387.99,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":33.63,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":33.63,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":33.63,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":258.66,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":439.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":258.66,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":137.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":232.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":90.53,"methodology":"percent of total billed charges"}]}]},{"description":"S 100 PEROX AB ","code_information":[{"code":"684642","type":"CDM"},{"code":"88342","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":701.80,"discounted_cash":701.80,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":35.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":182.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":63.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":161.41,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":561.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":645.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":421.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":189.49,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":133.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":91.23,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":185.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":315.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":122.81,"methodology":"percent of total billed charges"}]}]},{"description":"S 100 PEROX EACH ADDL AB ","code_information":[{"code":"712215","type":"CDM"},{"code":"88341","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":701.80,"discounted_cash":701.80,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":35.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":182.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":63.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":161.41,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":561.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":645.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":421.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":189.49,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":133.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":91.23,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":185.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":315.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":122.81,"methodology":"percent of total billed charges"}]}]},{"description":"S AGALACTIAE AG SSM ","code_information":[{"code":"709774","type":"CDM"},{"code":"87899","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":260.15,"discounted_cash":260.15,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":67.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":23.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":59.83,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":130.07,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":208.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":239.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":156.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":221.13,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":16.91,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":72.84,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":72.84,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":70.24,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":49.43,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":221.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":195.11,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":16.91,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":16.91,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":16.91,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":130.07,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":221.13,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":130.07,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":68.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":117.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":45.53,"methodology":"percent of total billed charges"}]}]},{"description":"SAA BY CLA ","code_information":[{"code":"710997","type":"CDM"},{"code":"82397","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":649.65,"discounted_cash":649.65,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":33.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":168.91,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":58.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":149.42,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":324.82,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":519.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":597.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":389.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":552.20,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.23,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":181.90,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":181.90,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":175.41,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":123.43,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":552.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":487.24,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.23,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.23,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.23,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":324.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":552.20,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":324.82,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":172.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":292.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":113.69,"methodology":"percent of total billed charges"}]}]},{"description":"SACUB/VALSART 24/26 TAB ","code_information":[{"code":"715871","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":64.00,"discounted_cash":64.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":3.26,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":15.23,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":5.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":15.23,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":9.15,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":16.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":5.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":14.72,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":7.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":3.01,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":8.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":13.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":8.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.25,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":32.00,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":11.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":14.21,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":51.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":58.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":38.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":54.40,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.16,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":17.92,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":17.92,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":17.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":12.16,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":54.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":48.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.16,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.16,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.16,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":8.32,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":32.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":54.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":32.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":16.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":28.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":11.20,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":64.00,"methodology":"percent of total billed charges"}]}]},{"description":"SC BX SALIVARY GLAND ","code_information":[{"code":"682610","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":10508.85,"discounted_cash":10508.85,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":535.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":851.22,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":493.92,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5254.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1933.63,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":2332.96,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8407.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":9668.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6305.31,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8932.52,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":683.08,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2837.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1996.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8932.52,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":7881.64,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":683.08,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":683.08,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":683.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5254.43,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8932.52,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5254.43,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4728.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1839.05,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":10508.85,"methodology":"percent of total billed charges"}]}]},{"description":"SC INJ ANESTH CELIAC PLX ","code_information":[{"code":"708646","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":9807.05,"discounted_cash":9807.05,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":500.16,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":794.37,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":460.93,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4903.52,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1804.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":2177.17,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7845.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":9022.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":5884.23,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8335.99,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":637.46,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2647.90,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1863.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8335.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":7355.29,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":637.46,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":637.46,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":637.46,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4903.52,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8335.99,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4903.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4413.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1716.23,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":9807.05,"methodology":"percent of total billed charges"}]}]},{"description":"SC PERC MECH THRMBTY INI ","code_information":[{"code":"688498","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":39414.54,"discounted_cash":39414.54,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":2010.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":3192.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1852.48,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":19707.27,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":7252.28,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":8750.03,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31531.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":36261.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":23648.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":33502.36,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2561.95,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":10641.93,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":7488.76,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":33502.36,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":29560.90,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2561.95,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2561.95,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2561.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":19707.27,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":33502.36,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":19707.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17736.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":6897.54,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":39414.54,"methodology":"percent of total billed charges"}]}]},{"description":"SC REMOVE NEHP TUBE W/F ","code_information":[{"code":"688285","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":9613.45,"discounted_cash":9613.45,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":490.29,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":778.69,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":451.83,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4806.73,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1768.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":2134.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7690.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":8844.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":5768.07,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8171.43,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":624.87,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2595.63,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1826.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8171.43,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":7210.09,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":624.87,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":624.87,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":624.87,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4806.73,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8171.43,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4806.73,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4326.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1682.35,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":9613.45,"methodology":"percent of total billed charges"}]}]},{"description":"SCOP 1MG/72HR PATCH ","code_information":[{"code":"708845","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":136.00,"discounted_cash":136.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":6.94,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":32.37,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":11.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":32.37,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":19.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":35.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":12.24,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":31.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":11.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":15.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":11.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":6.39,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":17.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":28.29,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":17.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":11.15,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":68.00,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":25.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":30.19,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":108.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":125.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":81.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":115.60,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.84,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":38.08,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":38.08,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":36.72,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":25.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":115.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":102.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.84,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.84,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.84,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":17.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":68.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":115.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":68.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":36.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":61.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":23.80,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":136.00,"methodology":"percent of total billed charges"}]}]},{"description":"SCOPOLAMINE 0.4MG INJ ","code_information":[{"code":"698894","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":99.48,"discounted_cash":99.48,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":5.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":23.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":8.06,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":23.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":14.23,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":25.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":8.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":22.88,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":8.16,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":11.44,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":8.16,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":4.68,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":12.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":20.69,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":12.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":8.16,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":18.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":22.08,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":79.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":91.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":59.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":84.56,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.47,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":26.86,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":18.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":84.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":74.61,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.47,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":12.93,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":84.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49.74,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":26.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":44.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":17.41,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":99.48,"methodology":"percent of total billed charges"}]}]},{"description":"SCOSSPRS LAPSCP MNPLR ","code_information":[{"code":"923454","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":273.77,"discounted_cash":273.77,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":13.96,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":65.16,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":22.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":65.16,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":39.15,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":71.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":24.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":62.97,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":22.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":31.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":22.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":12.87,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":35.32,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":56.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":35.32,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":22.45,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":136.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":50.37,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":60.78,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":219.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":251.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":164.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":232.70,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":17.80,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":76.66,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":76.66,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":73.92,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":52.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":232.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":205.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":17.80,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":17.80,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":17.80,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":35.59,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":136.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":232.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":136.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":72.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":123.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":47.91,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":273.77,"methodology":"percent of total billed charges"}]}]},{"description":"SCR 7X105MM CANN THRD ","code_information":[{"code":"968796","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":663.43,"discounted_cash":663.43,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":59.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":152.59,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":530.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":610.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":398.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":497.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":563.92,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":175.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":298.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":116.10,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW 100X11MM LAG ","code_information":[{"code":"898522","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1042.53,"discounted_cash":1042.53,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":271.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":93.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":239.78,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":834.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":959.13,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":625.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":781.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":886.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":521.26,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":276.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":469.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":182.44,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW 14MM VARIABLE NEUR ","code_information":[{"code":"912449","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":284.33,"discounted_cash":284.33,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":73.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":25.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":65.40,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":227.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":170.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":213.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":75.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":127.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":49.76,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW 2.0 TI CORT ","code_information":[{"code":"836293","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":206.99,"discounted_cash":206.99,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":53.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":18.63,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":47.61,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":103.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":165.59,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":190.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":124.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":175.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":175.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":155.24,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":103.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":175.94,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":103.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":54.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":93.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":36.22,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW 3.5 SHAFT 204.220 ","code_information":[{"code":"837994","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":60.50,"discounted_cash":60.50,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":15.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":5.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":13.91,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":30.25,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":48.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":55.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":36.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":51.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":51.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":45.38,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":30.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":51.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":30.25,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":16.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":27.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":10.59,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW 3.5MMX26MM CANN L ","code_information":[{"code":"991993","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW 4.0 CANN THR/30 ","code_information":[{"code":"837860","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":674.80,"discounted_cash":674.80,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":175.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":60.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":155.20,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":337.40,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":539.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":620.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":404.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":573.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":573.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":506.10,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":337.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":573.58,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":337.40,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":178.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":303.66,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":118.09,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW 4.0MMX40MM CANC ","code_information":[{"code":"944548","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":606.56,"discounted_cash":606.56,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":157.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":54.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":139.51,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":303.28,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":485.25,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":558.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":363.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":515.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":515.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":303.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":515.58,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":303.28,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":160.74,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":272.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":106.15,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW 4.5X45MM ","code_information":[{"code":"869313","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2464.15,"discounted_cash":2464.15,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":640.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":221.77,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":566.75,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1232.08,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1971.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2267.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1478.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2094.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2094.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1848.11,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1232.08,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2094.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1232.08,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":653.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1108.87,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":431.23,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW 8.5X45 ZDIAC PDCL ","code_information":[{"code":"941104","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2596.84,"discounted_cash":2596.84,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":675.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":233.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":597.27,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1298.42,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2077.47,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2389.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1558.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2207.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2207.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1947.63,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1298.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2207.31,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1298.42,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":688.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1168.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":454.45,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW ANTI ROTAT 95MM ","code_information":[{"code":"870398","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":94.78,"discounted_cash":94.78,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":24.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":8.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":21.80,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":75.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":87.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":56.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":71.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":25.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":42.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":16.59,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 1.4MM 3MM ","code_information":[{"code":"959277","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":159.22,"discounted_cash":159.22,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":41.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":14.33,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":36.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":127.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":146.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":95.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":42.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":71.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":27.86,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 1.5MM 12MM SS ","code_information":[{"code":"950623","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":146.48,"discounted_cash":146.48,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":38.08,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":13.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":33.69,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":73.24,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":117.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":134.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":87.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":124.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":124.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":109.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":73.24,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":124.51,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":73.24,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":38.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":65.92,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":25.63,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 1.7MM 11MM ","code_information":[{"code":"959230","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":278.45,"discounted_cash":278.45,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":72.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":25.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":64.04,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":139.22,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":222.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":256.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":167.07,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":236.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":236.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":208.84,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":139.22,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":236.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":139.22,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":73.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":125.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":48.73,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 1.7MM 14MM ","code_information":[{"code":"513812","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":303.58,"discounted_cash":303.58,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":78.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":27.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":69.82,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":151.79,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":242.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":279.29,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":182.15,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":258.04,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":258.04,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":227.69,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":151.79,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":258.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":151.79,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":80.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":136.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":53.13,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 1.7MM 16MM ","code_information":[{"code":"952725","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 1.7MM 20MM ","code_information":[{"code":"518616","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":386.99,"discounted_cash":386.99,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":100.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":34.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":89.01,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":309.59,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":356.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":232.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":328.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":328.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":290.24,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":328.94,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":102.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":174.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":67.72,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 1.7MM 20MM ","code_information":[{"code":"959268","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":320.53,"discounted_cash":320.53,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.34,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":28.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":73.72,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":160.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":256.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":294.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":192.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":272.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":272.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":240.40,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":160.26,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":272.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":160.26,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":84.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":144.24,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.09,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 1.7MM 24MM ","code_information":[{"code":"959266","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":320.53,"discounted_cash":320.53,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.34,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":28.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":73.72,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":160.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":256.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":294.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":192.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":272.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":272.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":240.40,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":160.26,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":272.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":160.26,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":84.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":144.24,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.09,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 1.7MM 6MM ","code_information":[{"code":"959229","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":278.45,"discounted_cash":278.45,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":72.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":25.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":64.04,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":139.22,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":222.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":256.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":167.07,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":236.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":236.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":208.84,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":139.22,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":236.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":139.22,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":73.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":125.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":48.73,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 1.7MM 8MM ","code_information":[{"code":"932942","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 1.7X16MM ","code_information":[{"code":"518612","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":303.58,"discounted_cash":303.58,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":78.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":27.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":69.82,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":151.79,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":242.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":279.29,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":182.15,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":258.04,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":258.04,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":227.69,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":151.79,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":258.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":151.79,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":80.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":136.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":53.13,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 10.5MM 100MM ","code_information":[{"code":"941338","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1990.28,"discounted_cash":1990.28,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":517.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":179.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":457.76,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1592.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1831.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1194.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1691.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1691.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1492.71,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1691.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":527.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":895.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":348.30,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 10.5MM 90MM ","code_information":[{"code":"937372","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1990.28,"discounted_cash":1990.28,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":517.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":179.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":457.76,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1592.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1831.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1194.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1691.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1691.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1492.71,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1691.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":995.14,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":527.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":895.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":348.30,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 10.5MM 95MM ","code_information":[{"code":"931340","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1440.58,"discounted_cash":1440.58,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":374.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":129.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":331.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":720.29,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1152.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1325.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":864.35,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1224.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1224.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1080.43,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":720.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1224.49,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":720.29,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":381.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":648.26,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":252.10,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.0MMX14MM ","code_information":[{"code":"532362","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2748.48,"discounted_cash":2748.48,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":714.60,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":247.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":632.15,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1374.24,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2198.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2528.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1649.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2336.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2336.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2061.36,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1374.24,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2336.21,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1374.24,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":728.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1236.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":480.98,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.0X18MM ","code_information":[{"code":"520345","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":159.22,"discounted_cash":159.22,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":41.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":14.33,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":36.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":127.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":146.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":95.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":42.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":71.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":27.86,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.0X22MM ","code_information":[{"code":"520347","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":159.22,"discounted_cash":159.22,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":41.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":14.33,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":36.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":127.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":146.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":95.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":42.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":71.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":27.86,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.3MM 10MM ","code_information":[{"code":"933872","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":337.40,"discounted_cash":337.40,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":87.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":30.37,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":77.60,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":168.70,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":269.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":310.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":202.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":286.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":286.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":253.05,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":168.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":286.79,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":168.70,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":89.41,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":151.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":59.05,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.3MM 16MM ","code_information":[{"code":"886596","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":414.66,"discounted_cash":414.66,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":107.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":37.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":95.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":207.33,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":331.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":381.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":248.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":352.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":352.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":311.00,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":207.33,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":352.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":207.33,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":109.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":186.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":72.57,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.3MM 16MM ","code_information":[{"code":"890227","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.3MM 16MM ","code_information":[{"code":"933838","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":469.48,"discounted_cash":469.48,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":122.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":42.25,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":107.98,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.74,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":375.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":431.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":281.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":399.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":399.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":352.11,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":399.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.74,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":124.41,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":211.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":82.16,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.3MM 18MM ","code_information":[{"code":"885679","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":414.66,"discounted_cash":414.66,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":107.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":37.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":95.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":207.33,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":331.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":381.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":248.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":352.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":352.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":311.00,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":207.33,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":352.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":207.33,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":109.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":186.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":72.57,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.3MM 20MM ","code_information":[{"code":"935443","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.3MM 22MM ","code_information":[{"code":"888780","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.3MM 22MM ","code_information":[{"code":"959877","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":351.88,"discounted_cash":351.88,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":91.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":31.67,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":80.93,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":175.94,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":281.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":323.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":211.13,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":299.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":299.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":263.91,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":175.94,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":299.10,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":175.94,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":93.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":158.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":61.58,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.3MM 26MM ","code_information":[{"code":"959242","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.3X14MM TI HND ","code_information":[{"code":"965356","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":320.53,"discounted_cash":320.53,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.34,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":28.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":73.72,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":160.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":256.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":294.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":192.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":272.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":272.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":240.40,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":160.26,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":272.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":160.26,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":84.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":144.24,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.09,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.4MM 16MM ","code_information":[{"code":"986554","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":286.90,"discounted_cash":286.90,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":74.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":25.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":65.99,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":143.45,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":229.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":263.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":172.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":243.86,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":243.86,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":215.18,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":143.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":243.86,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":143.45,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":76.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":129.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":50.21,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.4MM 18MM ","code_information":[{"code":"990947","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":379.10,"discounted_cash":379.10,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":98.57,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":87.19,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":189.55,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":303.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":348.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":227.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":322.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":322.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":189.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":322.24,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":189.55,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":100.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":170.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":66.34,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.4MM 18MM LCP ","code_information":[{"code":"967746","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":468.11,"discounted_cash":468.11,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":121.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":42.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":107.67,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.06,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":374.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":430.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":280.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":397.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":397.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":351.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":397.89,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.06,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":124.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":210.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":81.92,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.4MM 18MM SS ","code_information":[{"code":"926479","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":468.11,"discounted_cash":468.11,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":121.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":42.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":107.67,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.06,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":374.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":430.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":280.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":397.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":397.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":351.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":397.89,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.06,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":124.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":210.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":81.92,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.4MM 20MM LCP ","code_information":[{"code":"967747","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":468.11,"discounted_cash":468.11,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":121.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":42.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":107.67,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.06,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":374.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":430.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":280.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":397.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":397.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":351.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":397.89,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":234.06,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":124.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":210.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":81.92,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.4MM 22MM ","code_information":[{"code":"992112","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":602.77,"discounted_cash":602.77,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":156.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":54.25,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":138.64,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":301.38,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":482.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":554.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":361.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":512.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":512.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":452.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":301.38,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":512.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":301.38,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":159.73,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":271.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":105.48,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.5MM 21MM ANTH ","code_information":[{"code":"502646","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7MM 11M ","code_information":[{"code":"960348","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7MM 12MM ","code_information":[{"code":"988568","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":473.88,"discounted_cash":473.88,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":123.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":42.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":108.99,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":236.94,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":379.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":435.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":284.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":402.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":402.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":355.41,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":236.94,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":402.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":236.94,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":125.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":213.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":82.93,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7MM 22MM ","code_information":[{"code":"956675","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7MM 22MM ","code_information":[{"code":"957750","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7MM 24MM ","code_information":[{"code":"960405","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7MM 28MM ","code_information":[{"code":"960368","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7MM 2MM 14MM ","code_information":[{"code":"970730","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":447.34,"discounted_cash":447.34,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":116.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":40.26,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":102.89,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":223.67,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":357.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":411.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":268.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":380.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":380.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":335.50,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":223.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":380.24,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":223.67,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":118.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":201.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":78.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7MM 46MM VRX ","code_information":[{"code":"962573","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.98,"discounted_cash":344.98,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":89.69,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":31.05,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":79.35,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":317.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":206.99,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":293.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":293.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":258.74,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":293.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":172.49,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":91.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":155.24,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":60.37,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7MM 5MM 20MM ","code_information":[{"code":"838017","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.63,"discounted_cash":75.63,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.39,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.81,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.72,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.81,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.81,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.24,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7MM 5MM 22MM ","code_information":[{"code":"896354","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":120.74,"discounted_cash":120.74,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":31.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":10.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":27.77,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":60.37,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":96.59,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":111.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":72.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":102.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":102.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":90.56,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":60.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":102.63,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":60.37,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":32.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":54.33,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":21.13,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7MM 5MM 26MM ","code_information":[{"code":"879208","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.63,"discounted_cash":75.63,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.39,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.81,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.72,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.81,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.81,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.24,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.7X16MM ","code_information":[{"code":"926550","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":271.97,"discounted_cash":271.97,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":70.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":24.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":62.55,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":135.99,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":217.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":250.21,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":163.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":231.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":231.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":203.98,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":135.99,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":231.17,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":135.99,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":72.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":122.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":47.59,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2.8MM 16MM TI ","code_information":[{"code":"949314","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":599.28,"discounted_cash":599.28,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":155.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":53.94,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":137.83,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":299.64,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":479.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":551.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":359.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":509.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":509.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":449.46,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":299.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":509.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":299.64,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":158.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":269.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":104.87,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 20MM 4.5 DWD020 ","code_information":[{"code":"960750","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":283.38,"discounted_cash":283.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":73.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":25.50,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":65.18,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":141.69,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":226.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":260.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":170.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":240.87,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":240.87,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":212.53,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":141.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":240.87,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":141.69,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":75.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":127.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":49.59,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2MM 12MM ","code_information":[{"code":"929360","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":336.72,"discounted_cash":336.72,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":87.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":30.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":77.45,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":168.36,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":269.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":309.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":202.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":286.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":286.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":252.54,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":168.36,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":286.21,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":168.36,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":89.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":151.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":58.93,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2MM 16MM ","code_information":[{"code":"933447","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2MM 20MM ","code_information":[{"code":"962584","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":699.36,"discounted_cash":699.36,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":181.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":62.94,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":160.85,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":349.68,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":559.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":643.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":419.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":594.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":594.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":524.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":349.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":594.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":349.68,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":185.33,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":314.71,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":122.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 2MM 28MM ","code_information":[{"code":"959562","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":699.36,"discounted_cash":699.36,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":181.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":62.94,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":160.85,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":349.68,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":559.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":643.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":419.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":594.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":594.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":524.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":349.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":594.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":349.68,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":185.33,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":314.71,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":122.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 10MM ","code_information":[{"code":"930123","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":189.59,"discounted_cash":189.59,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":49.29,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":17.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":43.61,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.80,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":151.67,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":174.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":113.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":142.19,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.80,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":50.24,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":85.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":33.18,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 10MM ","code_information":[{"code":"976170","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2729.52,"discounted_cash":2729.52,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":709.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":245.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2183.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2511.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1637.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2320.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2320.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2047.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2320.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":723.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1228.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":477.67,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 10MM ","code_information":[{"code":"991238","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":159.22,"discounted_cash":159.22,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":41.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":14.33,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":36.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":127.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":146.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":95.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":119.42,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":135.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":79.61,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":42.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":71.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":27.86,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 12MM ","code_information":[{"code":"885921","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":382.89,"discounted_cash":382.89,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":99.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":34.46,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":88.06,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":191.44,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":306.31,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":352.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":229.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":325.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":325.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":287.17,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":191.44,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":325.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":191.44,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":101.47,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":172.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":67.01,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 16MM ","code_information":[{"code":"893947","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 16MM ","code_information":[{"code":"912958","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":94.78,"discounted_cash":94.78,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":24.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":8.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":21.80,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":75.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":87.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":56.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":71.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":25.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":42.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":16.59,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 16MM ","code_information":[{"code":"925437","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 16MM ","code_information":[{"code":"926348","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 16MM ","code_information":[{"code":"976171","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2729.52,"discounted_cash":2729.52,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":709.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":245.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":627.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2183.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2511.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1637.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2320.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2320.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2047.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2320.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":723.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1228.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":477.67,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 18MM ","code_information":[{"code":"885817","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":333.61,"discounted_cash":333.61,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":86.74,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":30.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":76.73,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":166.81,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":266.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":306.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":200.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":283.57,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":283.57,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":250.21,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":166.81,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":283.57,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":166.81,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":88.41,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":150.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":58.38,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 18MM ","code_information":[{"code":"941659","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1391.30,"discounted_cash":1391.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":361.74,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":125.22,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":320.00,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":695.65,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1113.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1280.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":834.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1182.61,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1182.61,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1043.47,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":695.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1182.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":695.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":368.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":626.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":243.48,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 20MM ","code_information":[{"code":"530509","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4886.60,"discounted_cash":4886.60,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1270.52,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":439.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1123.92,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2443.30,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3909.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4495.67,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2931.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4153.61,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4153.61,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3664.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2443.30,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4153.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2443.30,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1294.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2198.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":855.15,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 20MM ","code_information":[{"code":"999743","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1216.91,"discounted_cash":1216.91,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":316.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":109.52,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":279.89,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":608.46,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":973.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1119.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":730.15,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1034.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1034.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":912.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":608.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1034.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":608.46,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":322.48,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":547.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":212.96,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 22MM ","code_information":[{"code":"926398","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 24MM ","code_information":[{"code":"803137","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":426.71,"discounted_cash":426.71,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":110.94,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":38.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":98.14,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":213.35,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":341.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":392.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":256.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":362.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":362.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":320.03,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":213.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":362.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":213.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":113.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":192.02,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":74.67,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 24MM ","code_information":[{"code":"988933","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 28MM ","code_information":[{"code":"982791","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 34MM ","code_information":[{"code":"928239","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 36MM ","code_information":[{"code":"919106","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":242.85,"discounted_cash":242.85,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":63.14,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":21.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":55.86,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":121.42,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":194.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":223.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":145.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":206.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":206.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":182.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":121.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":206.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":121.42,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":64.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":109.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":42.50,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 38MM ","code_information":[{"code":"918462","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":338.35,"discounted_cash":338.35,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":87.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":30.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":77.82,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":169.18,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":270.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":311.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":203.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":287.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":287.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":253.76,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":169.18,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":287.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":169.18,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":89.66,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":152.26,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":59.21,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 38MM ","code_information":[{"code":"928552","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":37.91,"discounted_cash":37.91,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":9.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":3.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":8.72,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":18.95,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":34.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":22.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":32.22,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":32.22,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":28.43,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":18.95,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":32.22,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":18.95,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":10.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17.06,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":6.63,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 40MM ","code_information":[{"code":"970741","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":131.93,"discounted_cash":131.93,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":34.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":11.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":30.34,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":65.97,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":105.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":121.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":79.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":98.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":65.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":65.97,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":34.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":59.37,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":23.09,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 55MM ","code_information":[{"code":"916364","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":94.78,"discounted_cash":94.78,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":24.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":8.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":21.80,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":75.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":87.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":56.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":71.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":25.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":42.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":16.59,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 60MM ","code_information":[{"code":"998128","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":125.00,"discounted_cash":125.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":32.50,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":11.25,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":28.75,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":62.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":100.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":115.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":75.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":106.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":106.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":93.75,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":62.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":106.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":62.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":33.13,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":56.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":21.88,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 65MM ","code_information":[{"code":"901969","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 6MM 10MM ","code_information":[{"code":"837946","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":78.02,"discounted_cash":78.02,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":20.29,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":7.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.94,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.01,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":71.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":46.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":58.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.01,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":39.01,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":35.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.65,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 6MM 18MM ","code_information":[{"code":"930593","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":85.98,"discounted_cash":85.98,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":22.35,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":7.74,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":19.78,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":42.99,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":79.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":51.59,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":73.08,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":73.08,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":64.48,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":42.99,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":73.08,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":42.99,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":22.78,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":38.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":15.05,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 70MM ","code_information":[{"code":"928247","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":322.24,"discounted_cash":322.24,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":74.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":296.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":193.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":85.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":145.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 75MM ","code_information":[{"code":"916013","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 75MM ","code_information":[{"code":"968576","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":131.93,"discounted_cash":131.93,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":34.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":11.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":30.34,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":65.97,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":105.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":121.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":79.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":98.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":65.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":65.97,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":34.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":59.37,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":23.09,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM 8MM SPNL ","code_information":[{"code":"985072","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":379.10,"discounted_cash":379.10,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":98.57,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":87.19,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":189.55,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":303.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":348.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":227.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":322.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":322.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":189.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":322.24,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":189.55,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":100.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":170.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":66.34,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5MM105MM ","code_information":[{"code":"936171","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":119.42,"discounted_cash":119.42,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":31.05,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":10.75,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":27.47,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":59.71,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":95.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":109.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":71.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":101.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":101.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":89.56,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":59.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":101.51,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":59.71,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":31.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":53.74,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":20.90,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5X30MM ","code_information":[{"code":"944538","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":245.54,"discounted_cash":245.54,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":63.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":22.10,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":56.47,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":122.77,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":196.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":225.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":147.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":208.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":208.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":184.16,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":122.77,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":208.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":122.77,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":65.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":110.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":42.97,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5X38MM ","code_information":[{"code":"967435","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":131.93,"discounted_cash":131.93,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":34.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":11.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":30.34,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":65.97,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":105.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":121.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":79.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":98.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":65.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":65.97,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":34.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":59.37,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":23.09,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3.5X38MM ","code_information":[{"code":"994712","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":298.58,"discounted_cash":298.58,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":77.63,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":26.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":68.67,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":149.29,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":238.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":274.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":179.15,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":253.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":253.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":223.94,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":149.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":253.79,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":149.29,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":79.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":134.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":52.25,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3MM 10MM 4MM ","code_information":[{"code":"942735","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3MM 24MM ","code_information":[{"code":"935390","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":336.72,"discounted_cash":336.72,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":87.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":30.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":77.45,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":168.36,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":269.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":309.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":202.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":286.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":286.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":252.54,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":168.36,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":286.21,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":168.36,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":89.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":151.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":58.93,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3MM 32MM ","code_information":[{"code":"907831","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":181.97,"discounted_cash":181.97,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":47.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":16.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":41.85,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":145.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":167.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":109.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":136.48,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":154.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":90.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":48.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":81.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":31.84,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3MM 40MM 8MM ","code_information":[{"code":"928876","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 3X26X6MM ","code_information":[{"code":"944655","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":568.65,"discounted_cash":568.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":147.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":130.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":454.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":483.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":150.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":255.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":99.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4.0MM 36MM ","code_information":[{"code":"968757","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":473.88,"discounted_cash":473.88,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":123.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":42.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":108.99,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":236.94,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":379.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":435.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":284.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":402.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":402.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":355.41,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":236.94,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":402.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":236.94,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":125.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":213.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":82.93,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4.5MM 12MM ","code_information":[{"code":"989726","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":284.33,"discounted_cash":284.33,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":73.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":25.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":65.40,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":227.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":170.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":213.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":75.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":127.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":49.76,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4.5MM 28MM ","code_information":[{"code":"972083","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":189.55,"discounted_cash":189.55,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":49.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":17.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":43.60,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.78,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":151.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":174.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":113.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.78,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":50.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":85.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":33.17,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4.5MM 30MM ANKL ","code_information":[{"code":"967394","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":398.06,"discounted_cash":398.06,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":103.50,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":35.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":91.55,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":199.03,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":318.45,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":366.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":238.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":338.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":338.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":298.55,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":199.03,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":338.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":199.03,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":105.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":179.13,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":69.66,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4.5MM 36MM ","code_information":[{"code":"973238","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":189.55,"discounted_cash":189.55,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":49.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":17.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":43.60,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.78,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":151.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":174.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":113.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.78,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":50.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":85.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":33.17,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4.5MM 42MM ","code_information":[{"code":"846596","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":98.57,"discounted_cash":98.57,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":25.63,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":8.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":22.67,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49.28,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":78.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":90.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":59.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":73.93,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":83.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49.28,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":26.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":44.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":17.25,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4.5MM 46MM ","code_information":[{"code":"962303","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":379.10,"discounted_cash":379.10,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":98.57,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":87.19,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":189.55,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":303.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":348.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":227.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":322.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":322.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":284.32,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":189.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":322.24,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":189.55,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":100.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":170.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":66.34,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4.5MM 48MM ","code_information":[{"code":"529435","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":189.55,"discounted_cash":189.55,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":49.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":17.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":43.60,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.78,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":151.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":174.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":113.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":161.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":94.78,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":50.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":85.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":33.17,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4.5X90MM ","code_information":[{"code":"939990","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4MM 15MM ","code_information":[{"code":"990545","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":284.33,"discounted_cash":284.33,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":73.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":25.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":65.40,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":227.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":170.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":213.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":241.68,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":142.16,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":75.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":127.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":49.76,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4MM 16MM ","code_information":[{"code":"934539","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":689.66,"discounted_cash":689.66,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":179.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":62.07,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":158.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":344.83,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":551.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":634.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":413.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":586.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":586.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":517.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":344.83,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":586.21,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":344.83,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":182.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":310.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":120.69,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4MM 20MM ","code_information":[{"code":"872495","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":100.65,"discounted_cash":100.65,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":26.17,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":9.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":23.15,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":50.33,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":80.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":92.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":60.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":85.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":85.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":75.49,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":50.33,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":85.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":50.33,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":26.67,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":45.29,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":17.61,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 4MM 26MM ","code_information":[{"code":"864251","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":435.43,"discounted_cash":435.43,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":113.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":39.19,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":100.15,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":217.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":348.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":400.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":261.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":370.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":370.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":326.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":217.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":370.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":217.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":115.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":195.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":76.20,"methodology":"percent of total billed charges"}]}]},{"description":"TAVR PERC FEM APPROACH ","code_information":[{"code":"716895","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":132262.68,"discounted_cash":132262.68,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":6745.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":10713.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":6216.35,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":66131.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":24336.33,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":29362.31,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":105810.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":121681.67,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":79357.61,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112423.28,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8597.07,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":35710.92,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":25129.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112423.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":99197.01,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8597.07,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8597.07,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8597.07,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":66131.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":112423.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":66131.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":59518.21,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":23145.97,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":132262.68,"methodology":"percent of total billed charges"}]}]},{"description":"TC99M PENT AERS DX 75MCI ","drug_information":{"unit":"75","type":"UN"},"code_information":[{"code":"709661","type":"CDM"},{"code":"A9567","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":557.81,"discounted_cash":557.81,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":28.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":145.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":50.20,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":128.30,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":278.90,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":102.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":123.83,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":446.25,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":513.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":334.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":474.14,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.26,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":156.19,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":156.19,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":150.61,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":105.98,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":474.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":418.36,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.26,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.26,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":36.26,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":72.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":278.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":474.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":278.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":147.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":251.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":97.62,"methodology":"percent of total billed charges"}]}]},{"description":"TENACULUM FORCP 5MM 31CM ","code_information":[{"code":"971226","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2827.03,"discounted_cash":2827.03,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":144.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":672.83,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":228.99,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":672.83,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":404.27,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":735.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":254.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":650.22,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":231.82,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":325.11,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":231.82,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":132.87,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":364.69,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":588.02,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":364.69,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":231.82,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1413.52,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":520.17,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":627.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2261.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2600.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1696.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2402.98,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":183.76,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":791.57,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":791.57,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":763.30,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":537.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2402.98,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2120.27,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":183.76,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":183.76,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":183.76,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":367.51,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1413.52,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2402.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1413.52,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":749.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1272.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":494.73,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":2827.03,"methodology":"percent of total billed charges"}]}]},{"description":"TETANUS IG HUMAN 250 U ","drug_information":{"unit":"250","type":"UN"},"code_information":[{"code":"699297","type":"CDM"},{"code":"J1670","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1289.00,"discounted_cash":1289.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":335.14,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":116.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":296.47,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":105.70,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":148.24,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":105.70,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":166.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":268.11,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":166.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":105.70,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":644.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1031.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1185.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":773.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1095.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1095.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":966.75,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":644.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1095.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":644.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":341.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":580.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":225.57,"methodology":"percent of total billed charges"}]}]},{"description":"TETRACAINE 0.5% OPH ","code_information":[{"code":"699308","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":126.61,"discounted_cash":126.61,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":6.46,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":30.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":10.26,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":30.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":18.11,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":32.92,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":11.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":29.12,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":10.38,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":14.56,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":10.38,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":5.95,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":16.33,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":26.33,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":16.33,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":10.38,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":63.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":23.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":28.11,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":101.29,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":116.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":75.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":107.62,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.23,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":34.18,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":24.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":107.62,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":94.96,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.23,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.23,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.23,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":16.46,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":63.30,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":107.62,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":63.30,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":33.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":56.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":22.16,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":126.61,"methodology":"percent of total billed charges"}]}]},{"description":"THEOPHYLL 80MG/15ML LIQ ","code_information":[{"code":"699345","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":99.48,"discounted_cash":99.48,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":5.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":23.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":8.06,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":23.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":14.23,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":25.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":8.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":22.88,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":8.16,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":11.44,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":8.16,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":4.68,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":12.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":20.69,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":12.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":8.16,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":18.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":22.08,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":79.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":91.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":59.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":84.56,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.47,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":26.86,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":18.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":84.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":74.61,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.47,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":12.93,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":84.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49.74,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":26.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":44.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":17.41,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":99.48,"methodology":"percent of total billed charges"}]}]},{"description":"THER ACTIV DIR 15 MIN PT ","code_information":[{"code":"676610","type":"CDM"},{"code":"97530","type":"CPT"}],"standard_charges":[{"modifiers":"GP","modifiers_description":"Services delivered under an outpatient physical therapy plan of care","setting":"outpatient","gross_charge":319.57,"discounted_cash":319.57,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":16.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":28.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":73.50,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":159.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":58.80,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":70.94,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":255.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":294.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":191.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":271.63,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":89.48,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":89.48,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":86.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":60.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":271.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":239.68,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":41.54,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":159.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":271.63,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":159.78,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":84.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":143.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":55.92,"methodology":"percent of total billed charges"}]}]},{"description":"THER ACTIV DIR 15 MIN PT ","code_information":[{"code":"712434","type":"CDM"},{"code":"97530","type":"CPT"}],"standard_charges":[{"modifiers":"GP","modifiers_description":"Services delivered under an outpatient physical therapy plan of care","setting":"outpatient","gross_charge":319.57,"discounted_cash":319.57,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":16.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":28.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":73.50,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":159.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":58.80,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":70.94,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":255.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":294.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":191.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":271.63,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":89.48,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":89.48,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":86.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":60.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":271.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":239.68,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":41.54,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":159.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":271.63,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":159.78,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":84.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":143.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":55.92,"methodology":"percent of total billed charges"}]}]},{"description":"THER ACTIV DIR 15 MIN PT ","code_information":[{"code":"712785","type":"CDM"},{"code":"97530","type":"CPT"}],"standard_charges":[{"modifiers":"GP","modifiers_description":"Services delivered under an outpatient physical therapy plan of care","setting":"outpatient","gross_charge":319.57,"discounted_cash":319.57,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":16.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":83.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":28.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":73.50,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":159.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":58.80,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":70.94,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":255.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":294.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":191.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":271.63,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":89.48,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":89.48,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":86.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":60.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":271.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":239.68,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":41.54,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":159.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":271.63,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":159.78,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":84.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":143.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":55.92,"methodology":"percent of total billed charges"}]}]},{"description":"THER EXERCIS 15 MIN PTCQ ","code_information":[{"code":"719100","type":"CDM"},{"code":"97110","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","gross_charge":387.29,"discounted_cash":387.29,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":19.75,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":100.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":34.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":89.08,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.65,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":71.26,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":85.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":309.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":356.31,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":232.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":329.20,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":108.44,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":108.44,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":104.57,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":73.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":329.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":290.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":50.35,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":329.20,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":102.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":174.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":67.78,"methodology":"percent of total billed charges"}]}]},{"description":"THER EXERCISES 15 MIN OT ","code_information":[{"code":"713201","type":"CDM"},{"code":"97110","type":"CPT"}],"standard_charges":[{"modifiers":"GO","modifiers_description":"Services delivered under an outpatient occupational therapy plan of care","setting":"outpatient","gross_charge":387.29,"discounted_cash":387.29,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":19.75,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":100.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":34.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":89.08,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.65,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":71.26,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":85.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":309.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":356.31,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":232.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":329.20,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":108.44,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":108.44,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":104.57,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":73.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":329.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":290.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":50.35,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":329.20,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":102.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":174.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":67.78,"methodology":"percent of total billed charges"}]}]},{"description":"THER EXERCISES 15 MIN PT ","code_information":[{"code":"676600","type":"CDM"},{"code":"97110","type":"CPT"}],"standard_charges":[{"modifiers":"GP","modifiers_description":"Services delivered under an outpatient physical therapy plan of care","setting":"outpatient","gross_charge":387.29,"discounted_cash":387.29,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":19.75,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":100.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":34.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":89.08,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.65,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":71.26,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":85.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":309.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":356.31,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":232.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":329.20,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":108.44,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":108.44,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":104.57,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":73.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":329.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":290.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":25.17,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":50.35,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":329.20,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":193.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":102.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":174.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":67.78,"methodology":"percent of total billed charges"}]}]},{"description":"THORACENTESIS W/ IMAG ","code_information":[{"code":"705799","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":6074.00,"discounted_cash":6074.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":1445.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":491.99,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":1445.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":868.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":498.07,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":698.51,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":498.07,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":285.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":783.55,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":1263.39,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":783.55,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":498.07,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4859.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":5588.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":3644.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5162.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5162.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":4555.50,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":789.62,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3037.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5162.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3037.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1609.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2733.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1062.95,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":6074.00,"methodology":"percent of total billed charges"}]}]},{"description":"THROMBIN (RECOMB) 5MU VL ","code_information":[{"code":"704592","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1812.14,"discounted_cash":1812.14,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":92.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":431.29,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":146.78,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":431.29,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":259.14,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":471.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":163.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":416.79,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":148.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":208.40,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":148.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":85.17,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":233.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":376.93,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":233.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":148.60,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":906.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":333.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":402.30,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1449.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1667.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1087.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1540.32,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":117.79,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":489.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":344.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1540.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1359.11,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":117.79,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":117.79,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":117.79,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":235.58,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":906.07,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1540.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":906.07,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":480.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":815.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":317.12,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1812.14,"methodology":"percent of total billed charges"}]}]},{"description":"THROMBOLYSIS CORONARY IV ","code_information":[{"code":"677245","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3106.07,"discounted_cash":3106.07,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":158.41,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":251.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":145.99,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1553.04,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":571.52,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":689.55,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2484.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2857.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1863.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2640.16,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":201.89,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":838.64,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":590.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2640.16,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2329.55,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":201.89,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":201.89,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":201.89,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1553.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2640.16,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1553.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1397.73,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":543.56,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":3106.07,"methodology":"percent of total billed charges"}]}]},{"description":"THROMBOMOD EA ADD AB IHC ","code_information":[{"code":"712230","type":"CDM"},{"code":"88341","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":701.80,"discounted_cash":701.80,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":35.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":182.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":63.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":161.41,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":561.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":645.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":421.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":189.49,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":133.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":91.23,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":185.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":315.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":122.81,"methodology":"percent of total billed charges"}]}]},{"description":"THROMBOMODULIN AB IHC ","code_information":[{"code":"710301","type":"CDM"},{"code":"88342","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":701.80,"discounted_cash":701.80,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":35.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":182.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":63.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":161.41,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":561.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":645.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":421.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":189.49,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":133.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":91.23,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":185.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":315.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":122.81,"methodology":"percent of total billed charges"}]}]},{"description":"THYROXINE T4 TOTAL ","code_information":[{"code":"684734","type":"CDM"},{"code":"84436","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":410.19,"discounted_cash":410.19,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":20.92,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":106.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":36.92,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":94.34,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":205.09,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":328.15,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":377.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":246.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":348.66,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":26.66,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":114.85,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":114.85,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":110.75,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":77.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":348.66,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":307.64,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":26.66,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":26.66,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":26.66,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":205.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":348.66,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":205.09,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":108.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":184.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":71.78,"methodology":"percent of total billed charges"}]}]},{"description":"TIAGABINE 16MG TAB ","code_information":[{"code":"678370","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":100.61,"discounted_cash":100.61,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":5.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":23.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":8.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":23.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":14.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":26.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":9.05,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":23.14,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":8.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":11.57,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":8.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":4.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":12.98,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":20.93,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":12.98,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":8.25,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":50.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":18.51,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":22.34,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":80.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":92.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":60.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":85.52,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.54,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":27.16,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":19.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":85.52,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":75.46,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.54,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.54,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":6.54,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":13.08,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":50.30,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":85.52,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":50.30,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":26.66,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":45.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":17.61,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":100.61,"methodology":"percent of total billed charges"}]}]},{"description":"TIB IMP INS SZ3 15MM ","code_information":[{"code":"522051","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2085.05,"discounted_cash":2085.05,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":542.11,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":187.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":479.56,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1042.53,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1668.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1918.25,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1251.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1772.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1772.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1563.79,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1042.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1772.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1042.53,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":552.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":938.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":364.88,"methodology":"percent of total billed charges"}]}]},{"description":"TIBIA ORTOFFSET 3F/2T ","code_information":[{"code":"969579","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8378.11,"discounted_cash":8378.11,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2178.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":754.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1926.97,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6702.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7707.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":5026.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7121.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7121.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":6283.58,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7121.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2220.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3770.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1466.17,"methodology":"percent of total billed charges"}]}]},{"description":"TIP INSRTR KN DISP ","code_information":[{"code":"993099","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"TIS BSMNT MIGIF IND ADDL ","code_information":[{"code":"716212","type":"CDM"},{"code":"88350","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":363.00,"discounted_cash":363.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":18.51,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":94.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":32.67,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":83.49,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":181.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":290.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":333.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":217.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":308.55,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.59,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":101.64,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":101.64,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":98.01,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":68.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":308.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":272.25,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.59,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.59,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.59,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":47.19,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":181.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":308.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":181.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":96.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":163.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":63.52,"methodology":"percent of total billed charges"}]}]},{"description":"TISS CULT CHROM BLD NM ","code_information":[{"code":"686376","type":"CDM"},{"code":"88230","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":297.39,"discounted_cash":297.39,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":15.17,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":77.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":26.77,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":68.40,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":148.69,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":237.91,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":273.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":178.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":252.78,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":19.33,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":83.27,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":83.27,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":80.30,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":56.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":252.78,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":223.04,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":19.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":19.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":19.33,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":148.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":252.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":148.69,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":78.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":133.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":52.04,"methodology":"percent of total billed charges"}]}]},{"description":"TOLVAPTAN 15MG PO ","code_information":[{"code":"691839","type":"CDM"},{"code":"J8499","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2285.00,"discounted_cash":2285.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":594.10,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":205.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":525.55,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":187.37,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":262.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":187.37,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":294.76,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":475.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":294.76,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":187.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1142.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1828.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2102.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1371.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1942.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1942.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1713.75,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1142.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1942.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1142.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":605.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1028.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":399.88,"methodology":"percent of total billed charges"}]}]},{"description":"TOOL INSRTN TRNSVLVR 7FR ","code_information":[{"code":"925496","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":182.51,"discounted_cash":182.51,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":9.31,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":43.44,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":14.78,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":43.44,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":26.10,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":47.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":16.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":41.98,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.97,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":20.99,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.97,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":8.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":23.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":37.96,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":23.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.97,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":91.25,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":33.58,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":40.52,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":146.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":167.91,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":109.51,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":155.13,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.86,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":51.10,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":51.10,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":49.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":34.68,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":155.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":136.88,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.86,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.86,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.86,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":23.73,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":91.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":155.13,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":91.25,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":48.37,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":82.13,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":31.94,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":182.51,"methodology":"percent of total billed charges"}]}]},{"description":"TRACE METALS VL ","code_information":[{"code":"699579","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":118.70,"discounted_cash":118.70,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":6.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":28.25,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":9.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":28.25,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":16.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":30.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":10.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":27.30,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":9.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":13.65,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":9.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":5.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":15.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":24.69,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":15.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":9.73,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":59.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":21.84,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":26.35,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":94.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":109.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":71.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":100.89,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.72,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":32.05,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":22.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":100.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":89.03,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.72,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.72,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.72,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":15.43,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":59.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":100.89,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":59.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":31.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":53.41,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":20.77,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":118.70,"methodology":"percent of total billed charges"}]}]},{"description":"TRACH TUBE 7.5 UNCUFFED ","code_information":[{"code":"511077","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":342.44,"discounted_cash":342.44,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":17.46,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":81.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":27.74,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":81.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":48.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":89.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":30.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":78.76,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":28.08,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":39.38,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":28.08,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":16.09,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":44.17,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":71.23,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":44.17,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":28.08,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":171.22,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":63.01,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":76.02,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":273.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":315.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":205.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":291.07,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":22.26,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":95.88,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":95.88,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":92.46,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":65.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":291.07,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":256.83,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":22.26,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":22.26,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":22.26,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":44.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":171.22,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":291.07,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":171.22,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":90.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":59.93,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":342.44,"methodology":"percent of total billed charges"}]}]},{"description":"TRACTION MECHANCL PTCQ ","code_information":[{"code":"719268","type":"CDM"},{"code":"97012","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","gross_charge":262.55,"discounted_cash":262.55,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":13.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":68.26,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":23.63,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":60.39,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":131.28,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":48.31,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":58.29,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":210.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":241.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":157.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":223.17,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":17.07,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":73.51,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":73.51,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":70.89,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":49.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":223.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":196.91,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":17.07,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":17.07,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":17.07,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":34.13,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":131.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":223.17,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":131.28,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":69.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":118.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":45.95,"methodology":"percent of total billed charges"}]}]},{"description":"TRANS ANGIO SAME ART EAD ","code_information":[{"code":"717239","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":40543.47,"discounted_cash":40543.47,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":2067.72,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":3284.02,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1905.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":20271.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":7460.00,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":9000.65,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32434.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":37299.99,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":24326.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":34461.95,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2635.33,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":10946.74,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":7703.26,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":34461.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":30407.60,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2635.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2635.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2635.33,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":20271.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":34461.95,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":20271.74,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":18244.56,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":7095.11,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":40543.47,"methodology":"percent of total billed charges"}]}]},{"description":"TRANS ANGIO SAME ART INT ","code_information":[{"code":"717234","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":41396.52,"discounted_cash":41396.52,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":2111.22,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":3353.12,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1945.64,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":20698.26,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":7616.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":9190.03,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":33117.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":38084.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":24837.91,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":35187.04,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2690.77,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":11177.06,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":7865.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":35187.04,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":31047.39,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2690.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2690.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2690.77,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":20698.26,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":35187.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":20698.26,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":18628.43,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":7244.39,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":41396.52,"methodology":"percent of total billed charges"}]}]},{"description":"TRANSCTH STNT PLC IN VN ","code_information":[{"code":"707520","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":5760.81,"discounted_cash":5760.81,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":293.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":466.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":270.76,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2880.41,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1059.99,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":1278.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4608.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":5299.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":3456.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4896.69,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":374.45,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1555.42,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1094.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4896.69,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":4320.61,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":374.45,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":374.45,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":374.45,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2880.41,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4896.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2880.41,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2592.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1008.14,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":5760.81,"methodology":"percent of total billed charges"}]}]},{"description":"TRAY BONE MARROW W ","code_information":[{"code":"821292","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":254.03,"discounted_cash":254.03,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":12.96,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":60.46,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":20.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":60.46,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":36.33,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":66.05,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":22.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":58.43,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":20.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":29.21,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":20.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":11.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":32.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":52.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":32.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":20.83,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":127.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":46.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":56.39,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":203.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":233.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":152.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":215.93,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":16.51,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":71.13,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":71.13,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":68.59,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":48.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":215.93,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":190.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":16.51,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":16.51,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":16.51,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":33.02,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":127.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":215.93,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":127.02,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":67.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":114.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":44.46,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":254.03,"methodology":"percent of total billed charges"}]}]},{"description":"TRAY BX 11G 152MM ","code_information":[{"code":"989306","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"TRAY CATH PICC 2L 5FR ","code_information":[{"code":"934950","type":"CDM"},{"code":"C1751","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"}]}]},{"description":"TRAY CATH PICC 5FR 70CM ","code_information":[{"code":"976701","type":"CDM"},{"code":"C1751","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"}]}]},{"description":"TRAY CATH SRSTP LBRSL ST ","code_information":[{"code":"515799","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":115.32,"discounted_cash":115.32,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":5.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":27.45,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":9.34,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":27.45,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":16.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":29.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":10.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":26.52,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":9.46,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":13.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":9.46,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":5.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":14.88,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":23.99,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":14.88,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":9.46,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":57.66,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":21.22,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":25.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":92.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":106.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":69.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":98.02,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":32.29,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":32.29,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":31.14,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":21.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":98.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":86.49,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.50,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.50,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":7.50,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":14.99,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":57.66,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":98.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":57.66,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":30.56,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":51.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":20.18,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":115.32,"methodology":"percent of total billed charges"}]}]},{"description":"TRAY HUM +12MM 0MM ","code_information":[{"code":"913320","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2274.60,"discounted_cash":2274.60,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":591.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":204.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":523.16,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1137.30,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1819.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2092.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1933.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1933.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1705.95,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1137.30,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1933.41,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1137.30,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":602.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1023.57,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":398.06,"methodology":"percent of total billed charges"}]}]},{"description":"TRAY INTRO KPHPK XPNDR ","code_information":[{"code":"954189","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":10950.30,"discounted_cash":10950.30,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":558.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":2606.17,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":886.97,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":2606.17,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":1565.89,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2847.08,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":985.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2518.57,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":897.92,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":1259.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":897.92,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":514.66,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1412.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":2277.66,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1412.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":897.92,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5475.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":2014.86,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":2430.97,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8760.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":10074.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6570.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9307.75,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":711.77,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":3066.08,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":3066.08,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2956.58,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":2080.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9307.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":8212.73,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":711.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":711.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":711.77,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":1423.54,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5475.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9307.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5475.15,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2901.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4927.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1916.30,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":10950.30,"methodology":"percent of total billed charges"}]}]},{"description":"TRAY ORT 4F 3T OFFST TIB ","code_information":[{"code":"950269","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8378.11,"discounted_cash":8378.11,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2178.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":754.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1926.97,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6702.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7707.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":5026.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7121.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7121.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":6283.58,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7121.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2220.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3770.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1466.17,"methodology":"percent of total billed charges"}]}]},{"description":"TRAY ORT TIB TRAPEZOID ","code_information":[{"code":"969522","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4549.20,"discounted_cash":4549.20,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1182.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":409.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1046.32,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2274.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3639.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4185.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2729.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3866.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3866.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3411.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2274.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3866.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2274.60,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1205.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2047.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":796.11,"methodology":"percent of total billed charges"}]}]},{"description":"TRAY TIB CEM 80MM ","code_information":[{"code":"900725","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3791.00,"discounted_cash":3791.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":985.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":341.19,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":871.93,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1895.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3032.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3487.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2274.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3222.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3222.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2843.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1895.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3222.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1895.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1004.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1705.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":663.42,"methodology":"percent of total billed charges"}]}]},{"description":"TRAY TIBIAL CEMENT 3F/4T ","code_information":[{"code":"893091","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7297.68,"discounted_cash":7297.68,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1897.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":656.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1678.47,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3648.84,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5838.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6713.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4378.61,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6203.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6203.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5473.26,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3648.84,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6203.03,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3648.84,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1933.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3283.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1277.09,"methodology":"percent of total billed charges"}]}]},{"description":"TRCR LPSCP 110MM 15MM ","code_information":[{"code":"922274","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"TRIAMCINOLN ACE PF 40MG ","drug_information":{"unit":"40","type":"ME"},"code_information":[{"code":"705525","type":"CDM"},{"code":"J3300","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1978.00,"discounted_cash":1978.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":514.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":178.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":454.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":162.20,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":227.47,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":162.20,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":255.16,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":411.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":255.16,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":162.20,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":989.00,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1582.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1819.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1186.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1681.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1681.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1483.50,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":989.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1681.30,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":989.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":524.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":890.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":346.15,"methodology":"percent of total billed charges"}]}]},{"description":"TRIAMTER/HCTZ 75/50 TAB ","code_information":[{"code":"695805","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15.83,"discounted_cash":15.83,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.81,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":3.77,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1.28,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":3.77,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":2.26,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.30,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":1.82,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.30,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.74,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":2.04,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":3.29,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":2.04,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.30,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7.92,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":2.91,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":3.51,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":14.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":9.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13.46,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.03,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":4.27,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":3.01,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":11.87,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.03,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.03,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.03,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":2.06,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7.92,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7.92,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2.77,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":15.83,"methodology":"percent of total billed charges"}]}]},{"description":"TRIFLURIDINE 1% 7.5ML OP ","code_information":[{"code":"699684","type":"CDM"},{"code":"S5000","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1125.00,"discounted_cash":1125.00,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":91.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":292.50,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":101.25,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":258.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":92.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":129.38,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":92.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":52.88,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":145.13,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":234.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":145.13,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":92.25,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":562.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":900.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1035.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":675.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":956.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":956.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":843.75,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":562.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":956.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":562.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":298.13,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":506.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":196.88,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1125.00,"methodology":"percent of total billed charges"}]}]},{"description":"TROCAR LAPSCP 11MM 100MM ","code_information":[{"code":"951200","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":216.73,"discounted_cash":216.73,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":11.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":51.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":17.56,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":51.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":30.99,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":56.35,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":19.51,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":49.85,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":17.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":24.92,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":17.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":10.19,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":27.96,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":45.08,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":27.96,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":17.77,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":108.36,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":39.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":48.11,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":173.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":199.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":130.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":184.22,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":14.09,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":60.68,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":60.68,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":58.52,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":41.18,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":184.22,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":162.55,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":14.09,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":14.09,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":14.09,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":28.17,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":108.36,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":184.22,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":108.36,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":57.43,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":97.53,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":37.93,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":216.73,"methodology":"percent of total billed charges"}]}]},{"description":"TROCAR LAPSCP 12MM 100MM ","code_information":[{"code":"951218","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":775.68,"discounted_cash":775.68,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":39.56,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":184.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":62.83,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":184.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":110.92,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":201.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":69.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":178.41,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":63.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":89.20,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":63.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":36.46,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":100.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":161.34,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":100.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":63.61,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":387.84,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":142.73,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":172.20,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":620.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":713.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":465.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":659.33,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":50.42,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":217.19,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":217.19,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":209.43,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":147.38,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":659.33,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":581.76,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":50.42,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":50.42,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":50.42,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":100.84,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":387.84,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":659.33,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":387.84,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":205.56,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":349.06,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":135.74,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":775.68,"methodology":"percent of total billed charges"}]}]},{"description":"TRYPSIN SERUM/PLASMA RIA ","code_information":[{"code":"709481","type":"CDM"},{"code":"83519","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":912.80,"discounted_cash":912.80,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":46.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":237.33,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":82.15,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":209.94,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":456.40,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":730.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":839.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":547.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":775.88,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":59.33,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":255.58,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":255.58,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":246.46,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":173.43,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":775.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":684.60,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":59.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":59.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":59.33,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":456.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":775.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":456.40,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":241.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":410.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":159.74,"methodology":"percent of total billed charges"}]}]},{"description":"TSH PEROX AB ","code_information":[{"code":"710304","type":"CDM"},{"code":"88342","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":701.80,"discounted_cash":701.80,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":35.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":182.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":63.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":161.41,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":561.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":645.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":421.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":189.49,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":133.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":91.23,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":185.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":315.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":122.81,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE 20FR BLN REPL BLSTR ","code_information":[{"code":"923891","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":307.99,"discounted_cash":307.99,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":15.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":73.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":24.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":73.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":44.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":80.08,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":27.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":70.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":25.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":35.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":25.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":14.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":39.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":64.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":39.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":25.26,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":154.00,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":56.67,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":68.37,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":246.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":283.35,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":184.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":261.79,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.02,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":86.24,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":86.24,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":83.16,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":58.52,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":261.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":230.99,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.02,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.02,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":20.02,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":40.04,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":154.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":261.79,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":154.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":81.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":138.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":53.90,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE FD 10FR 55IN ","code_information":[{"code":"513345","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":676.21,"discounted_cash":676.21,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":34.49,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":160.94,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":54.77,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":160.94,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":96.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":175.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":60.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":155.53,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":55.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":77.76,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":55.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":31.78,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":87.23,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":140.65,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":87.23,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":55.45,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":338.11,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":124.42,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":150.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":540.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":622.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":405.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":574.78,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":43.95,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":189.34,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":189.34,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":182.58,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":128.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":574.78,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":507.16,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":43.95,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":43.95,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":43.95,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":87.91,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":338.11,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":574.78,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":338.11,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":179.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":304.29,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":118.34,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":676.21,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE FD 8FR 22IN ","code_information":[{"code":"503283","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":54.64,"discounted_cash":54.64,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":2.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":13.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":4.43,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":13.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":7.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":14.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":4.92,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":12.57,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":6.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":2.57,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":7.05,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":11.37,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":7.05,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.48,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":27.32,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":10.05,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":12.13,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":43.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":50.27,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":32.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":46.44,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.55,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":15.30,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":15.30,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":14.75,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":10.38,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":46.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":40.98,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.55,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.55,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.55,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":7.10,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":27.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":46.44,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":27.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":14.48,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":24.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":9.56,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":54.64,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE FD MED 16F ","code_information":[{"code":"808704","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":216.50,"discounted_cash":216.50,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":11.04,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":51.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":17.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":51.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":30.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":56.29,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":19.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":49.80,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":17.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":24.90,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":17.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":10.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":27.93,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":45.03,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":27.93,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":17.75,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":108.25,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":39.84,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":48.06,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":173.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":199.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":129.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":184.03,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":14.07,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":60.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":60.62,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":58.45,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":41.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":184.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":162.38,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":14.07,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":14.07,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":14.07,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":28.14,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":108.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":184.03,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":108.25,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":57.37,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":97.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":37.89,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":216.50,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE FEEDING 20FR 51CM ","code_information":[{"code":"934600","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE GASTRO 18F 20CC BLN ","code_information":[{"code":"958479","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":177.04,"discounted_cash":177.04,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":9.03,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":42.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":14.34,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":42.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":25.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":46.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":15.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":40.72,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.52,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":20.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.52,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":8.32,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":22.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":36.82,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":22.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.52,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":88.52,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":32.58,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":39.30,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":141.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":162.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":106.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":150.48,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.51,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":49.57,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":49.57,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":47.80,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":33.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":150.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":132.78,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.51,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.51,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.51,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":23.02,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":88.52,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":150.48,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":88.52,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":46.92,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":79.67,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":30.98,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":177.04,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE GASTROJEJUNAL 22FR ","code_information":[{"code":"970028","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE GSTRM 18FRX18IN ","code_information":[{"code":"866973","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1309.28,"discounted_cash":1309.28,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":66.77,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":311.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":106.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":311.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":187.23,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":340.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":117.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":301.13,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":107.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":150.57,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":107.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":61.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":168.90,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":272.33,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":168.90,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":107.36,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":654.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":240.91,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":290.66,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1047.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1204.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":785.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1112.89,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":85.10,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":366.60,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":366.60,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":353.51,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":248.76,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1112.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":981.96,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":85.10,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":85.10,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":85.10,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":170.21,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":654.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1112.89,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":654.64,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":346.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":589.18,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":229.12,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1309.28,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE GSTRM LP 20FX2.5 ","code_information":[{"code":"864527","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1003.82,"discounted_cash":1003.82,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":51.19,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":238.91,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":81.31,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":238.91,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":143.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":260.99,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":90.34,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":230.88,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":82.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":115.44,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":82.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":47.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":129.49,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":208.79,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":129.49,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":82.31,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":501.91,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":184.70,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":222.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":803.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":923.51,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":602.29,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":853.25,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":65.25,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":281.07,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":281.07,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":271.03,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":190.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":853.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":752.87,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":65.25,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":65.25,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":65.25,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":130.50,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":501.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":853.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":501.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":266.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":451.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":175.67,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1003.82,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE INNR 10X8.9X13.8MM ","code_information":[{"code":"833819","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":431.75,"discounted_cash":431.75,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":22.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":102.76,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":34.97,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":102.76,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":61.74,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":112.25,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":38.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":99.30,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":35.40,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":49.65,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":35.40,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":20.29,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":55.70,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":89.80,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":55.70,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":35.40,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":215.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":79.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":95.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":345.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":397.21,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":259.05,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":366.99,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":28.06,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":120.89,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":120.89,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":116.57,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":82.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":366.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":323.81,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":28.06,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":28.06,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":28.06,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":56.13,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":215.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":366.99,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":215.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":114.41,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":194.29,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":75.56,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":431.75,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE JJNSTM 1.7CM 14FR ","code_information":[{"code":"967787","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE JJNSTM 16FR MIC ","code_information":[{"code":"514406","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE JJNSTM 16FR SIL STD ","code_information":[{"code":"924109","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE NASOGASTRIC 12FR ","code_information":[{"code":"833332","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":9.58,"discounted_cash":9.58,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.49,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":2.28,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":0.78,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":2.28,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":1.37,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":0.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2.20,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.79,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.79,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1.24,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":1.99,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1.24,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4.79,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1.76,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":2.13,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":8.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":5.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.14,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":2.68,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":2.68,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2.59,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1.82,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":7.18,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.62,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":1.25,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4.79,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4.79,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1.68,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":9.58,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE ORTH 52 TFLN DISP ","code_information":[{"code":"804443","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE PLATE 14 HOLE 150 D ","code_information":[{"code":"968686","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1709.74,"discounted_cash":1709.74,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":444.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":153.88,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":393.24,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":854.87,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1367.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1572.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1025.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1453.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1453.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1282.31,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":854.87,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1453.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":854.87,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":453.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":769.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":299.20,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE SET ARTHSCP 10FT ","code_information":[{"code":"886203","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":357.04,"discounted_cash":357.04,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":18.21,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":84.98,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":28.92,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":84.98,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":51.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":92.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":32.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":82.12,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":29.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":41.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":29.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":16.78,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":46.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":74.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":46.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":29.28,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":178.52,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":65.70,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":79.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":285.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":328.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":214.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":303.48,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.21,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":99.97,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":99.97,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":96.40,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":67.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":303.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":267.78,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.21,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.21,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.21,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":46.42,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":178.52,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":303.48,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":178.52,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":94.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":160.67,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":62.48,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":357.04,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE TRACH 12.7MM 79MM ","code_information":[{"code":"513480","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":415.33,"discounted_cash":415.33,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":21.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":98.85,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":33.64,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":98.85,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":59.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":107.99,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":37.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":95.53,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":34.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":47.76,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":34.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":19.52,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":53.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":86.39,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":53.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":34.06,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":207.66,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":76.42,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":92.20,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":332.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":382.10,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":249.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":353.03,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":27.00,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":116.29,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":116.29,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":112.14,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":78.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":353.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":311.50,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":27.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":27.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":27.00,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":53.99,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":207.66,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":353.03,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":207.66,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":110.06,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":186.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":72.68,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":415.33,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE TRACH 8.9X13.8X81MM ","code_information":[{"code":"833824","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":664.57,"discounted_cash":664.57,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":33.89,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":158.17,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":53.83,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":158.17,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":95.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":172.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":59.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":152.85,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":54.49,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":76.43,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":54.49,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":31.23,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":85.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":138.23,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":85.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":54.49,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":332.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":122.28,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":147.53,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":531.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":611.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":398.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":564.88,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":43.20,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":186.08,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":186.08,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":179.43,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":126.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":564.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":498.43,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":43.20,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":43.20,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":43.20,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":86.39,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":332.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":564.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":332.29,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":176.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":299.06,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":116.30,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":664.57,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE TRACH 8MM 105MM ","code_information":[{"code":"894998","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":602.18,"discounted_cash":602.18,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":30.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":143.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":48.78,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":143.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":86.11,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":156.57,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":54.20,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":138.50,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":49.38,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":69.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":49.38,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":28.30,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":77.68,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":125.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":77.68,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":49.38,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":301.09,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":110.80,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":133.68,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":481.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":554.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":361.31,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":511.85,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":39.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":168.61,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":168.61,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":162.59,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":114.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":511.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":451.63,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":39.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":39.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":39.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":78.28,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":301.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":511.85,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":301.09,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":159.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":270.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":105.38,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":602.18,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE TRACH 8MM 130MM ","code_information":[{"code":"850884","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1140.69,"discounted_cash":1140.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":58.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":92.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":271.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":163.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":296.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":262.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":131.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":53.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":237.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":147.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":93.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":209.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":253.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":912.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1049.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":684.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":319.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":307.99,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":216.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":855.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":74.14,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":148.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":969.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":570.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":302.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":513.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.62,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1140.69,"methodology":"percent of total billed charges"}]}]},{"description":"TUBE TRACH CUF SZ 8 ","code_information":[{"code":"833835","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":333.77,"discounted_cash":333.77,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":17.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":79.44,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":27.04,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":79.44,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":47.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":86.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":30.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":76.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":27.37,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":38.38,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":27.37,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":15.69,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":43.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":69.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":43.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":27.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":166.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":74.10,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":267.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":200.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":283.70,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.70,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":93.46,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":93.46,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":90.12,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":63.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":283.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":250.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.70,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":43.39,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":166.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":283.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":166.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":88.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":150.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":58.41,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":333.77,"methodology":"percent of total billed charges"}]}]},{"description":"TUBIN ANGIO 1200 P148IN ","code_information":[{"code":"862338","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":68.90,"discounted_cash":68.90,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":3.51,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":16.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":5.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":16.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":9.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":17.91,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.20,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":15.85,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.65,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":7.92,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.65,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":3.24,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":8.89,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":14.33,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":8.89,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":5.65,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":34.45,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":12.68,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":15.30,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":55.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":63.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":41.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":58.57,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.48,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":19.29,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":19.29,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":18.60,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":13.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":58.57,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":51.67,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.48,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.48,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.48,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":8.96,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":34.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":58.57,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":34.45,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":18.26,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":31.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":12.06,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":68.90,"methodology":"percent of total billed charges"}]}]},{"description":"TUBING 36 M TO F ","code_information":[{"code":"827953","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21.10,"discounted_cash":21.10,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":1.08,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":5.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":5.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":3.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":5.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1.90,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":4.85,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":2.43,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.99,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":2.72,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":4.39,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":2.72,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.73,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":10.55,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":3.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":4.68,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":19.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":12.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17.94,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.37,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":5.91,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":5.91,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":5.70,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":4.01,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":15.82,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.37,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.37,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.37,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":2.74,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":10.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17.94,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":10.55,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":5.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3.69,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":21.10,"methodology":"percent of total billed charges"}]}]},{"description":"TUBING EXT HIGH POWER ","code_information":[{"code":"971256","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":39.92,"discounted_cash":39.92,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":2.04,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":9.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":3.23,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":9.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":5.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":10.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":3.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":9.18,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.27,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":4.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.27,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1.88,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":5.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":8.30,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":5.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.27,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":19.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":7.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":8.86,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":36.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":23.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":33.93,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.59,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":11.18,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":11.18,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":10.78,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":7.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":33.93,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":29.94,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.59,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.59,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.59,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":5.19,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":19.96,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":33.93,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":19.96,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":10.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":6.99,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":39.92,"methodology":"percent of total billed charges"}]}]},{"description":"TUBING INSFL 10FT ","code_information":[{"code":"819122","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":53.27,"discounted_cash":53.27,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":2.72,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":12.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":4.31,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":12.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":7.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":13.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":4.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":12.25,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.37,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":6.13,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.37,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":2.50,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":6.87,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":11.08,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":6.87,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":26.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":9.80,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":11.83,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":49.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":31.96,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":45.28,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.46,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":14.92,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":14.92,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":14.38,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":10.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":45.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":39.95,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.46,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.46,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.46,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":6.93,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":26.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":45.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":26.64,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":14.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":23.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":9.32,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":53.27,"methodology":"percent of total billed charges"}]}]},{"description":"TUBING INSFL 10FT LL CON ","code_information":[{"code":"874836","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":73.23,"discounted_cash":73.23,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":3.73,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":17.43,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":5.93,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":17.43,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":10.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":16.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":6.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":8.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":6.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":3.44,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":9.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":15.23,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":9.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":6.00,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":36.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":13.47,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":16.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":58.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":67.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":43.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":62.25,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.76,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":20.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":20.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":19.77,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":13.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":62.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":54.92,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.76,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.76,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.76,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":9.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":36.62,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":62.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":36.62,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":19.41,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":32.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":12.82,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":73.23,"methodology":"percent of total billed charges"}]}]},{"description":"TUBING INTUBATION 30CM ","code_information":[{"code":"975307","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":73.23,"discounted_cash":73.23,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":3.73,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":17.43,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":5.93,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":17.43,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":10.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":16.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":6.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":8.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":6.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":3.44,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":9.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":15.23,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":9.45,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":6.00,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":36.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":13.47,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":16.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":58.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":67.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":43.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":62.25,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.76,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":20.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":20.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":19.77,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":13.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":62.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":54.92,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.76,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.76,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":4.76,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":9.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":36.62,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":62.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":36.62,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":19.41,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":32.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":12.82,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":73.23,"methodology":"percent of total billed charges"}]}]},{"description":"TUBING IRR CASS DISP ","code_information":[{"code":"962709","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":533.85,"discounted_cash":533.85,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":27.23,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":127.06,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":43.24,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":127.06,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":76.34,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":138.80,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":48.05,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":122.79,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":43.78,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":61.39,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":43.78,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":25.09,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":68.87,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":111.04,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":68.87,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":43.78,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":266.93,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":98.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":118.51,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":427.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":491.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":320.31,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":453.77,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":34.70,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":149.48,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":149.48,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":144.14,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":101.43,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":453.77,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":400.39,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":34.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":34.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":34.70,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":69.40,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":266.93,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":453.77,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":266.93,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":141.47,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":240.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":93.42,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":533.85,"methodology":"percent of total billed charges"}]}]},{"description":"TUBING PRSS MNTR 72IN ","code_information":[{"code":"803115","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":31.71,"discounted_cash":31.71,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":1.62,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":7.55,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":2.57,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":7.55,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":4.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":8.24,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":7.29,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":3.65,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1.49,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":4.09,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":6.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":4.09,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":15.86,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":5.83,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":7.04,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":29.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":19.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":26.95,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.06,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":8.88,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":8.88,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":8.56,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":6.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":26.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":23.78,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.06,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.06,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.06,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":4.12,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":15.86,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":26.95,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":15.86,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":8.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":5.55,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":31.71,"methodology":"percent of total billed charges"}]}]},{"description":"UA W MICRO MANUAL ","code_information":[{"code":"709762","type":"CDM"},{"code":"81000","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":15.23,"discounted_cash":15.23,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1.37,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3.50,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7.62,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":14.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":9.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12.95,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.99,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":4.26,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":4.26,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":4.11,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":2.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":11.42,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.99,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.99,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.99,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7.62,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12.95,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7.62,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2.67,"methodology":"percent of total billed charges"}]}]},{"description":"ULTRASOUND/15 MIN PTCQ ","code_information":[{"code":"719289","type":"CDM"},{"code":"97035","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","gross_charge":330.26,"discounted_cash":330.26,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":16.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":85.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":75.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":165.13,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":60.77,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":73.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":264.21,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":303.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":198.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":280.72,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.47,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":92.47,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":92.47,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":89.17,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":62.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":280.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":247.69,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.47,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":42.93,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":165.13,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":280.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":165.13,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":87.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":148.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":57.80,"methodology":"percent of total billed charges"}]}]},{"description":"ULTRASOUND/15 MIN PTCQ ","code_information":[{"code":"719294","type":"CDM"},{"code":"97035","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","gross_charge":330.26,"discounted_cash":330.26,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":16.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":85.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":29.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":75.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":165.13,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":60.77,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":73.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":264.21,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":303.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":198.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":280.72,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.47,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":92.47,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":92.47,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":89.17,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":62.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":280.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":247.69,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.47,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":21.47,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":42.93,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":165.13,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":280.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":165.13,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":87.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":148.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":57.80,"methodology":"percent of total billed charges"}]}]},{"description":"UPPER GI ENDO W/PLACE GT ","code_information":[{"code":"709609","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":9097.70,"discounted_cash":9097.70,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":463.98,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":736.91,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":746.01,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":1046.24,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":746.01,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":427.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1173.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":1892.32,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1173.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":746.01,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4548.85,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1673.98,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":2019.69,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7278.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":8369.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":5458.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7733.05,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":591.35,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2456.38,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1728.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7733.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":6823.27,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":591.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":591.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":591.35,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4548.85,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7733.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4548.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4093.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1592.10,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":9097.70,"methodology":"percent of total billed charges"}]}]},{"description":"UPPER GI ENDO W/SNARE TE ","code_information":[{"code":"675731","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":12641.51,"discounted_cash":12641.51,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":644.72,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1023.96,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1036.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":1453.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1036.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":594.15,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1630.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":2629.43,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":1630.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1036.60,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6320.76,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":2326.04,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":2806.42,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10113.21,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":11630.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":7584.91,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10745.28,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":821.70,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":3413.21,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":2401.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10745.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":9481.13,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":821.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":821.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":821.70,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6320.76,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10745.28,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6320.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5688.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2212.26,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":12641.51,"methodology":"percent of total billed charges"}]}]},{"description":"URSODIOL 300MG CAP ","code_information":[{"code":"699778","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":37.31,"discounted_cash":37.31,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":1.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":8.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":3.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":8.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":5.34,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":9.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":3.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":8.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":4.29,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1.75,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":4.81,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":7.76,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":4.81,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.06,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":18.66,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":6.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":8.28,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":34.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":22.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31.71,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.43,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":10.07,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":7.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":27.98,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.43,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.43,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.43,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":4.85,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":18.66,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":18.66,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":9.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":6.53,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":37.31,"methodology":"percent of total billed charges"}]}]},{"description":"US AAA SCREEN ","code_information":[{"code":"717169","type":"CDM"},{"code":"76706","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":1110.78,"discounted_cash":1110.78,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":56.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":288.80,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":99.97,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":255.48,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":555.39,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":888.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1021.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":666.47,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":944.16,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":72.20,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":311.02,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":311.02,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":299.91,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":211.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":944.16,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":833.09,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":72.20,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":72.20,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":72.20,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":555.39,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":944.16,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":555.39,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":294.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":499.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":194.39,"methodology":"percent of total billed charges"}]}]},{"description":"US BRST BI W AX LTD ","code_information":[{"code":"711853","type":"CDM"},{"code":"76642","type":"CPT"}],"standard_charges":[{"modifiers":"50","modifiers_description":"Bilateral Procedure","setting":"outpatient","gross_charge":4855.73,"discounted_cash":4855.73,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":247.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1262.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":437.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1116.82,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2427.86,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3884.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4467.27,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2913.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4127.37,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":315.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1359.60,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1359.60,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1311.05,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":922.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4127.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3641.80,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":315.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":315.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":315.62,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2427.86,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4127.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2427.86,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1286.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2185.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":849.75,"methodology":"percent of total billed charges"}]}]},{"description":"US BRST BX 1ST LESION LT ","code_information":[{"code":"707477","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7707.70,"discounted_cash":7707.70,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":393.09,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":624.32,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":362.26,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3853.85,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1418.22,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":1711.11,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6166.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7091.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4624.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6551.55,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":501.00,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2081.08,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1464.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6551.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5780.77,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":501.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":501.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":501.00,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3853.85,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6551.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3853.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3468.47,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1348.85,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":7707.70,"methodology":"percent of total billed charges"}]}]},{"description":"US BRST UNI W AX COMP ","code_information":[{"code":"711854","type":"CDM"},{"code":"76641","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":4855.73,"discounted_cash":4855.73,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":247.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1262.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":437.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1116.82,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2427.86,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3884.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4467.27,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2913.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4127.37,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":315.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1359.60,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1359.60,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1311.05,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":922.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4127.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3641.80,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":315.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":315.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":315.62,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2427.86,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4127.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2427.86,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1286.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2185.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":849.75,"methodology":"percent of total billed charges"}]}]},{"description":"US DVC PLC BRST 1ST LT ","code_information":[{"code":"707483","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":5840.67,"discounted_cash":5840.67,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":297.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":473.09,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":274.51,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2920.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":1074.68,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":1296.63,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4672.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":5373.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":3504.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4964.57,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":379.64,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1576.98,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1109.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4964.57,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":4380.50,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":379.64,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":379.64,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":379.64,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2920.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4964.57,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2920.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2628.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1022.12,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":5840.67,"methodology":"percent of total billed charges"}]}]},{"description":"US DVC PLC BRST 1ST RT ","code_information":[{"code":"707484","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1216.05,"discounted_cash":1216.05,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":62.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":98.50,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":57.15,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":608.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":223.75,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":269.96,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":972.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1118.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":729.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1033.64,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":79.04,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":328.33,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":231.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1033.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":912.04,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":79.04,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":79.04,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":79.04,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":608.02,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1033.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":608.02,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":547.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":212.81,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":1216.05,"methodology":"percent of total billed charges"}]}]},{"description":"US EXTR NON VASC LTD LT ","code_information":[{"code":"704904","type":"CDM"},{"code":"76882","type":"CPT"}],"standard_charges":[{"modifiers":"LT","modifiers_description":"Left side (Used to identify procedures performed on the left side of the body)","setting":"outpatient","gross_charge":1052.70,"discounted_cash":1052.70,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":53.69,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":273.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":94.74,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":242.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":842.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":968.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":631.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":894.79,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.43,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":294.76,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":294.76,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":284.23,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":200.01,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":894.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":789.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.43,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.43,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.43,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":894.79,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":278.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":473.71,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":184.22,"methodology":"percent of total billed charges"}]}]},{"description":"US FET BIO PH PR W/O NST ","code_information":[{"code":"683423","type":"CDM"},{"code":"76819","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":3262.16,"discounted_cash":3262.16,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":166.37,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":848.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":293.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":750.30,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1631.08,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2609.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3001.19,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1957.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2772.84,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":212.04,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":913.40,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":913.40,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":880.78,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":619.81,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2772.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2446.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":212.04,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":212.04,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":212.04,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1631.08,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2772.84,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1631.08,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":864.47,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1467.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":570.88,"methodology":"percent of total billed charges"}]}]},{"description":"US GUIDANCE VASC ACCESS ","code_information":[{"code":"681091","type":"CDM"},{"code":"76937","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":5423.22,"discounted_cash":5423.22,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":276.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1410.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":488.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1247.34,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2711.61,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4338.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4989.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":3253.93,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4609.74,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":352.51,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1518.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1518.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1464.27,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1030.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4609.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":4067.41,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":352.51,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":352.51,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":352.51,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2711.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4609.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2711.61,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1437.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2440.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":949.06,"methodology":"percent of total billed charges"}]}]},{"description":"US PRG 1ST TRI EA ADD ","code_information":[{"code":"679462","type":"CDM"},{"code":"76802","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":1052.70,"discounted_cash":1052.70,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":53.69,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":273.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":94.74,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":242.12,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":842.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":968.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":631.62,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":894.79,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.43,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":294.76,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":294.76,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":284.23,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":200.01,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":894.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":789.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.43,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.43,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":68.43,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":894.79,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":278.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":473.71,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":184.22,"methodology":"percent of total billed charges"}]}]},{"description":"US RETROPERITONEAL COM ","code_information":[{"code":"681879","type":"CDM"},{"code":"76770","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":5633.76,"discounted_cash":5633.76,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":287.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1464.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":507.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1295.76,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2816.88,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4507.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":5183.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":3380.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4788.70,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":366.19,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1577.45,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1577.45,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1521.12,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1070.41,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4788.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":4225.32,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":366.19,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":366.19,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":366.19,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2816.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4788.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2816.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1492.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2535.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":985.91,"methodology":"percent of total billed charges"}]}]},{"description":"VAL AOR PERICARDIAL 27MM ","code_information":[{"code":"814337","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":17688.81,"discounted_cash":17688.81,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1432.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4599.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1591.99,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":4068.43,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":831.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8844.41,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14151.05,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":16273.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":10613.29,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15035.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15035.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":13266.61,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8844.41,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15035.49,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8844.41,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4687.53,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7959.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3095.54,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":17688.81,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AOR TAVR 26MM ","code_information":[{"code":"912729","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":87180.00,"discounted_cash":87180.00,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":7061.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":22666.80,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":7846.20,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":20051.40,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":4097.46,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43590.00,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":69744.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":80205.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":52308.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74103.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74103.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":65385.00,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43590.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74103.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":43590.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":23102.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":39231.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":15256.50,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":87180.00,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 19MM ","code_information":[{"code":"895127","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":19334.10,"discounted_cash":19334.10,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1566.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":5026.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1740.07,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":4446.84,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":908.70,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9667.05,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15467.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":17787.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":11600.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16433.98,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16433.98,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":14500.58,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9667.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16433.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9667.05,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":5123.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8700.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3383.47,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":19334.10,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 19MM ","code_information":[{"code":"902111","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15467.28,"discounted_cash":15467.28,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1252.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4021.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1392.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3557.47,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":726.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7733.64,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12373.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":14229.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":9280.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13147.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13147.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":11600.46,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7733.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13147.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7733.64,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4098.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6960.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2706.77,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":15467.28,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 19MM ","code_information":[{"code":"914062","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":27295.20,"discounted_cash":27295.20,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":2210.91,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":7096.75,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2456.57,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":6277.90,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1282.87,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":13647.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21836.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":25111.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":16377.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23200.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23200.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":20471.40,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":13647.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23200.92,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":13647.60,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":7233.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12282.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":4776.66,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":27295.20,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 21MM ","code_information":[{"code":"911533","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":13647.60,"discounted_cash":13647.60,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1105.46,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3548.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1228.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3138.95,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":641.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10918.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":12555.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":8188.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11600.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11600.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":10235.70,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11600.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3616.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6141.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2388.33,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":13647.60,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 21MM ","code_information":[{"code":"914061","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":28432.50,"discounted_cash":28432.50,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":2303.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":7392.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2558.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":6539.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1336.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":14216.25,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22746.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":26157.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":17059.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24167.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24167.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":21324.38,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":14216.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24167.63,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":14216.25,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":7534.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12794.63,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":4975.69,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":28432.50,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 21MM ","code_information":[{"code":"929733","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":22727.05,"discounted_cash":22727.05,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1840.89,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":5909.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2045.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":5227.22,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1068.17,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11363.52,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18181.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":20908.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":13636.23,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19317.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19317.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":17045.29,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11363.52,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19317.99,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11363.52,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":6022.67,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10227.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3977.23,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":22727.05,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 23M ","code_information":[{"code":"812025","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":22404.81,"discounted_cash":22404.81,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1814.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":5825.25,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2016.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":5153.11,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1053.03,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11202.41,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17923.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":20612.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":13442.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19044.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19044.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":16803.61,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11202.41,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19044.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11202.41,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":5937.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10082.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3920.84,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":22404.81,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 23MM ","code_information":[{"code":"834482","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":13647.60,"discounted_cash":13647.60,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1105.46,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3548.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1228.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3138.95,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":641.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10918.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":12555.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":8188.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11600.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11600.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":10235.70,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11600.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3616.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6141.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2388.33,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":13647.60,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 23MM ","code_information":[{"code":"882819","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15164.00,"discounted_cash":15164.00,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1228.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3942.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3487.72,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":712.71,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7582.00,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12131.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":13950.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":9098.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12889.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12889.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":11373.00,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7582.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12889.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7582.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4018.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2653.70,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":15164.00,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 23MM ","code_information":[{"code":"911532","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":13647.60,"discounted_cash":13647.60,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1105.46,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3548.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1228.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3138.95,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":641.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10918.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":12555.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":8188.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11600.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11600.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":10235.70,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11600.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3616.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6141.42,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2388.33,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":13647.60,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 25MM ","code_information":[{"code":"882822","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15827.43,"discounted_cash":15827.43,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1282.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4115.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1424.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3640.31,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":743.89,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7913.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12661.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":14561.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":9496.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13453.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13453.32,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":11870.57,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7913.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13453.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7913.72,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4194.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7122.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2769.80,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":15827.43,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 25MM ","code_information":[{"code":"997625","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":18754.08,"discounted_cash":18754.08,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1519.08,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4876.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1687.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":4313.44,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":881.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9377.04,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15003.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":17253.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":11252.45,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15940.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15940.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":14065.56,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9377.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15940.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9377.04,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4969.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8439.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3281.96,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":18754.08,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 2800-25MM ","code_information":[{"code":"853055","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":17688.81,"discounted_cash":17688.81,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1432.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4599.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1591.99,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":4068.43,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":831.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8844.41,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14151.05,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":16273.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":10613.29,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15035.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15035.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":13266.61,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8844.41,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15035.49,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8844.41,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4687.53,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7959.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3095.54,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":17688.81,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE AORTIC 29MM ","code_information":[{"code":"918775","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":17776.00,"discounted_cash":17776.00,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1439.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4621.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1599.84,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":4088.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":835.47,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8888.00,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14220.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":16353.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":10665.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15109.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15109.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":13332.00,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8888.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15109.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8888.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4710.64,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7999.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3110.80,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":17776.00,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE MITRAL 25MM ","code_information":[{"code":"834490","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15543.10,"discounted_cash":15543.10,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1258.99,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4041.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1398.88,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3574.91,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":730.53,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7771.55,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12434.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":14299.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":9325.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13211.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13211.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":11657.33,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7771.55,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13211.64,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7771.55,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4118.92,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6994.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2720.04,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":15543.10,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE MITRAL 27MM ","code_information":[{"code":"865292","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":19675.29,"discounted_cash":19675.29,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1593.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":5115.58,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1770.78,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":4525.32,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":924.74,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9837.65,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15740.23,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":18101.27,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":11805.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16724.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16724.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":14756.47,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9837.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16724.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9837.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":5213.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8853.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3443.18,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":19675.29,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE TAVR 23MM ","code_information":[{"code":"525520","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":98804.00,"discounted_cash":98804.00,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":8003.12,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":25689.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":8892.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":22724.92,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":4643.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49402.00,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":79043.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":90899.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":59282.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":83983.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":83983.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":74103.00,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49402.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":83983.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":49402.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":26183.06,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":44461.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":17290.70,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":98804.00,"methodology":"percent of total billed charges"}]}]},{"description":"VALVE TISSUE MOD 3000-19 ","code_information":[{"code":"882900","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":22404.81,"discounted_cash":22404.81,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1814.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":5825.25,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2016.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":5153.11,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1053.03,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11202.41,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17923.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":20612.43,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":13442.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19044.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19044.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":16803.61,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11202.41,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19044.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11202.41,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":5937.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10082.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3920.84,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":22404.81,"methodology":"percent of total billed charges"}]}]},{"description":"VCAM BY CLA ","code_information":[{"code":"710996","type":"CDM"},{"code":"82397","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":649.65,"discounted_cash":649.65,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":33.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":168.91,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":58.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":149.42,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":324.82,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":519.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":597.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":389.79,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":552.20,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.23,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":181.90,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":181.90,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":175.41,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":123.43,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":552.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":487.24,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.23,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.23,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":42.23,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":324.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":552.20,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":324.82,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":172.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":292.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":113.69,"methodology":"percent of total billed charges"}]}]},{"description":"VDRL CSF QUAL ","code_information":[{"code":"686451","type":"CDM"},{"code":"86592","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":151.78,"discounted_cash":151.78,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":7.74,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":39.46,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":13.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":34.91,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":75.89,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":121.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":139.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":91.07,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":129.01,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":9.87,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":42.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":42.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":40.98,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":28.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":129.01,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":113.83,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":9.87,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":9.87,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":9.87,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":75.89,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":129.01,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":75.89,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":40.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":68.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":26.56,"methodology":"percent of total billed charges"}]}]},{"description":"VERAPAMIL 180MG CAP SA ","code_information":[{"code":"699830","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":23.74,"discounted_cash":23.74,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":1.21,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":5.65,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1.92,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":5.65,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":3.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":6.17,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2.14,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":5.46,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.95,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":2.73,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.95,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1.12,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":3.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":4.94,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":3.06,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.95,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":4.37,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":5.27,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18.99,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":21.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":14.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20.18,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.54,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":6.41,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":4.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20.18,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":17.80,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.54,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.54,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.54,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":3.09,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11.87,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20.18,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":11.87,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":6.29,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":4.15,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":23.74,"methodology":"percent of total billed charges"}]}]},{"description":"VERAPAMIL 5MG AMP ","code_information":[{"code":"708861","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":31.65,"discounted_cash":31.65,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":1.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":7.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":2.56,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":7.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":4.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":8.23,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":2.85,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":7.28,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":3.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1.49,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":4.08,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":6.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":4.08,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":15.82,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":5.82,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":7.03,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":29.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":18.99,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":26.90,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.06,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":8.55,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":6.01,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":26.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":23.74,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.06,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.06,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.06,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":4.11,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":15.82,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":26.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":15.82,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":8.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14.24,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":5.54,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":31.65,"methodology":"percent of total billed charges"}]}]},{"description":"VITAMIN A ","code_information":[{"code":"686461","type":"CDM"},{"code":"84590","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":12.28,"discounted_cash":12.28,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.63,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3.19,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1.11,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2.82,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6.14,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9.82,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":11.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":7.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10.44,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":3.44,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":3.44,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":3.32,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":2.33,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":9.21,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10.44,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6.14,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5.53,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2.15,"methodology":"percent of total billed charges"}]}]},{"description":"VITAMIN D 1-25 W/WO FRAC ","code_information":[{"code":"686469","type":"CDM"},{"code":"82652","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":12.53,"discounted_cash":12.53,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3.26,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2.88,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6.26,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":11.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":7.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10.65,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.81,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":3.51,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":3.51,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":3.38,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":2.38,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":9.40,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.81,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.81,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.81,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6.26,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6.26,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5.64,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2.19,"methodology":"percent of total billed charges"}]}]},{"description":"WALKING BOOTOPEN HEEL XL ","code_information":[{"code":"969844","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":287.91,"discounted_cash":287.91,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":14.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":68.52,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":23.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":68.52,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":41.17,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":74.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":25.91,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":66.22,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":23.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":33.11,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":23.61,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":13.53,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":37.14,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":59.89,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":37.14,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":23.61,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":143.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":52.98,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":63.92,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":230.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":264.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":172.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":244.72,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":18.71,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":80.61,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":80.61,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":77.74,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":54.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":244.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":215.93,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":18.71,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":18.71,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":18.71,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":37.43,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":143.96,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":244.72,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":143.96,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":76.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":129.56,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":50.38,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":287.91,"methodology":"percent of total billed charges"}]}]},{"description":"WARFARIN 3MG TAB ","code_information":[{"code":"699904","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":19.22,"discounted_cash":19.22,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.98,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":4.57,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1.56,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":4.57,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":5.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1.73,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":4.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":2.21,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.58,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.90,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":2.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":4.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":2.48,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":1.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9.61,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":3.54,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":4.27,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":17.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":11.53,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16.34,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.25,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":5.19,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":3.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":14.41,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.25,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.25,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":1.25,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":2.50,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16.34,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":9.61,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":5.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3.36,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":19.22,"methodology":"percent of total billed charges"}]}]},{"description":"WASHER DVLP EX FIX ANKL ","code_information":[{"code":"967390","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":128.89,"discounted_cash":128.89,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":33.51,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":11.60,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":29.64,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":64.44,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":103.11,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":118.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":77.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":109.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":109.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":96.67,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":64.44,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":109.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":64.44,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":34.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":58.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":22.56,"methodology":"percent of total billed charges"}]}]},{"description":"WASHER ORT/4.0 CAN SCREW ","code_information":[{"code":"925436","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":75.82,"discounted_cash":75.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":19.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":6.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":60.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":45.49,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":56.86,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":20.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":13.27,"methodology":"percent of total billed charges"}]}]},{"description":"WASHER ORTH 1.0MM 9MM ","code_information":[{"code":"875213","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":129.50,"discounted_cash":129.50,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":33.67,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":11.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":29.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":64.75,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":103.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":119.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":77.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":110.08,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":110.08,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":97.13,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":64.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":110.08,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":64.75,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":34.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":58.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":22.66,"methodology":"percent of total billed charges"}]}]},{"description":"WASHER ORTHO 6.5X3.0 ","code_information":[{"code":"955608","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":105.20,"discounted_cash":105.20,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":27.35,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":9.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":24.20,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":84.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":96.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":63.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":78.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89.42,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":52.60,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":27.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":47.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":18.41,"methodology":"percent of total billed charges"}]}]},{"description":"WASHER THREADED 3.0 ","code_information":[{"code":"880504","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":471.30,"discounted_cash":471.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":122.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":42.42,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":108.40,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":235.65,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":377.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":433.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":282.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":400.61,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":400.61,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":353.48,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":235.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":400.61,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":235.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":124.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":212.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":82.48,"methodology":"percent of total billed charges"}]}]},{"description":"WHIRLPOOL PT ","code_information":[{"code":"713176","type":"CDM"},{"code":"97022","type":"CPT"}],"standard_charges":[{"modifiers":"GP","modifiers_description":"Services delivered under an outpatient physical therapy plan of care","setting":"outpatient","gross_charge":459.76,"discounted_cash":459.76,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":23.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":119.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":41.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":105.74,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":229.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":84.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":102.07,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":367.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":422.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":275.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":390.80,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":128.73,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":128.73,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":124.14,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":87.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":390.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":344.82,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":59.77,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":229.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":390.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":229.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":121.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":206.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":80.46,"methodology":"percent of total billed charges"}]}]},{"description":"WHIRLPOOL PTCQ ","code_information":[{"code":"719069","type":"CDM"},{"code":"97022","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","gross_charge":459.76,"discounted_cash":459.76,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":23.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":119.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":41.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":105.74,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":229.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":84.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":102.07,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":367.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":422.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":275.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":390.80,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":128.73,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":128.73,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":124.14,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":87.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":390.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":344.82,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":59.77,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":229.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":390.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":229.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":121.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":206.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":80.46,"methodology":"percent of total billed charges"}]}]},{"description":"WHIRLPOOL PTCQ ","code_information":[{"code":"719178","type":"CDM"},{"code":"97022","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","gross_charge":459.76,"discounted_cash":459.76,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":23.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":119.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":41.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":105.74,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":229.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":84.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":102.07,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":367.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":422.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":275.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":390.80,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":128.73,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":128.73,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":124.14,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":87.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":390.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":344.82,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":29.88,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":59.77,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":229.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":390.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":229.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":121.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":206.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":80.46,"methodology":"percent of total billed charges"}]}]},{"description":"WIRE CERCLAGE 280X1MM ","code_information":[{"code":"836998","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":20.62,"discounted_cash":20.62,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":1.67,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":5.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":4.74,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.97,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":10.31,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":18.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":12.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":15.46,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":10.31,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":10.31,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":5.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3.61,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":20.62,"methodology":"percent of total billed charges"}]}]},{"description":"WIRE CRLGE 175MM .6MM ","code_information":[{"code":"946112","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":311.17,"discounted_cash":311.17,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":25.20,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":80.90,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":28.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":71.57,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":14.62,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":155.59,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":248.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":286.28,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":186.70,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":264.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":264.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":233.38,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":155.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":264.49,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":155.59,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":82.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":140.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":54.45,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":311.17,"methodology":"percent of total billed charges"}]}]},{"description":"WIRE FX KRSH 1.6MM ","code_information":[{"code":"931421","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":431.18,"discounted_cash":431.18,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":21.99,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":102.62,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":34.93,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":102.62,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":61.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":112.11,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":38.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":99.17,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":35.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":49.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":35.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":20.27,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":55.62,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":89.69,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":55.62,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":35.36,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":215.59,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":79.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":95.72,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":344.94,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":396.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":258.71,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":366.50,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":28.03,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":120.73,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":120.73,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":116.42,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":81.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":366.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":323.38,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":28.03,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":28.03,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":28.03,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":56.05,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":215.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":366.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":215.59,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":114.26,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":194.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":75.46,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":431.18,"methodology":"percent of total billed charges"}]}]},{"description":"WIRE ORTH 50MM 1MM KRSHN ","code_information":[{"code":"809718","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":360.15,"discounted_cash":360.15,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":18.37,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":85.72,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":29.17,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":85.72,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":51.50,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":93.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":32.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":82.83,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":29.53,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":41.42,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":29.53,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":16.93,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":46.46,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":74.91,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":46.46,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":29.53,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":180.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":66.27,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":79.95,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":288.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":331.34,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":216.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":306.13,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.41,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":100.84,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":100.84,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":97.24,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":68.43,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":306.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":270.11,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.41,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.41,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":23.41,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":46.82,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":180.07,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":306.13,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":180.07,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":95.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":162.07,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":63.03,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":360.15,"methodology":"percent of total billed charges"}]}]},{"description":"WIREDRIVER BRUSH ","code_information":[{"code":"971273","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":171.11,"discounted_cash":171.11,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":8.73,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":40.72,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":13.86,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":40.72,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":24.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":44.49,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":15.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":39.36,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.03,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":19.68,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.03,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":8.04,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":22.07,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":35.59,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":22.07,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":14.03,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":85.56,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":31.48,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":37.99,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":136.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":157.42,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":102.67,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":145.44,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.12,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":47.91,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":47.91,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":46.20,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":32.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":145.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":128.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.12,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.12,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":11.12,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":22.24,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":85.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":145.44,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":85.56,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":45.34,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":77.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":29.94,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":171.11,"methodology":"percent of total billed charges"}]}]},{"description":"WRIST SUPPORT ARTER HAND ","code_information":[{"code":"972945","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":40.27,"discounted_cash":40.27,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":2.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":9.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":3.26,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":9.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":5.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":10.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":3.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":9.26,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.30,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":4.63,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.30,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":1.89,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":5.19,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":8.38,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":5.19,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":3.30,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":20.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":7.41,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":8.94,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":37.05,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":24.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":34.23,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":11.28,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":11.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":10.87,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":7.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":34.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":30.20,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":2.62,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":5.24,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":20.14,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":34.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":20.14,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":10.67,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":18.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":7.05,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":40.27,"methodology":"percent of total billed charges"}]}]},{"description":"WRK HDCON 2 HRS INT PTCQ ","code_information":[{"code":"719191","type":"CDM"},{"code":"97545","type":"CPT"}],"standard_charges":[{"modifiers":"GP|CQ","modifiers_description":"Services delivered under an outpatient physical therapy plan of care|Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant","setting":"outpatient","gross_charge":1097.71,"discounted_cash":1097.71,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":55.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":285.40,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":98.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":252.47,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":548.86,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":201.98,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":243.69,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":878.17,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1009.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":658.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":933.05,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":71.35,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":307.36,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":307.36,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":296.38,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":208.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":933.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":823.28,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":71.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":71.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":71.35,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":142.70,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":548.86,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":933.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":548.86,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":290.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":493.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":192.10,"methodology":"percent of total billed charges"}]}]},{"description":"XENON XE133 GAS DX 10MCI ","drug_information":{"unit":"10","type":"UN"},"code_information":[{"code":"688169","type":"CDM"},{"code":"A9558","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":620.73,"discounted_cash":620.73,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":31.66,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":161.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":55.87,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":142.77,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":310.37,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":114.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":137.80,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":496.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":571.07,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":372.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":527.62,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":40.35,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":173.80,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":173.80,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":167.60,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":117.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":527.62,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":465.55,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":40.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":40.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":40.35,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":80.69,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":310.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":527.62,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":310.37,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":164.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":279.33,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":108.63,"methodology":"percent of total billed charges"}]}]},{"description":"XR ARTHROGRAM WRIST RT ","code_information":[{"code":"678321","type":"CDM"},{"code":"73115","type":"CPT"}],"standard_charges":[{"modifiers":"RT","modifiers_description":"Right side (Used to identify procedures performed on the right side of the body)","setting":"outpatient","gross_charge":3942.40,"discounted_cash":3942.40,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":201.06,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1025.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":354.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":906.75,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1971.20,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3153.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3627.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2365.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3351.04,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":256.26,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1103.87,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1103.87,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1064.45,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":749.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3351.04,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2956.80,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":256.26,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":256.26,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":256.26,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1971.20,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3351.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1971.20,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1044.74,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1774.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":689.92,"methodology":"percent of total billed charges"}]}]},{"description":"XR BONE LENGTH STUDIES ","code_information":[{"code":"690047","type":"CDM"},{"code":"77073","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":738.08,"discounted_cash":738.08,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":37.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":191.90,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":66.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":169.76,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":369.04,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":590.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":679.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":442.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":627.37,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":206.66,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":206.66,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":199.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":140.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":627.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":553.56,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":369.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":627.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":369.04,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":195.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":332.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":129.16,"methodology":"percent of total billed charges"}]}]},{"description":"XR ELBOW 3 + V RT ","code_information":[{"code":"680341","type":"CDM"},{"code":"73080","type":"CPT"}],"standard_charges":[{"modifiers":"RT","modifiers_description":"Right side (Used to identify procedures performed on the right side of the body)","setting":"outpatient","gross_charge":3479.34,"discounted_cash":3479.34,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":177.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":904.63,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":313.14,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":800.25,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1739.67,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2783.47,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3200.99,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2087.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2957.44,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":226.16,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":974.22,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":974.22,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":939.42,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":661.07,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2957.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2609.51,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":226.16,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":226.16,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":226.16,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1739.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2957.44,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1739.67,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":922.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1565.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":608.88,"methodology":"percent of total billed charges"}]}]},{"description":"XR ENEMA W/ AIR ","code_information":[{"code":"680459","type":"CDM"},{"code":"74280","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":7343.47,"discounted_cash":7343.47,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":374.52,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1909.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":660.91,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1689.00,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3671.74,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5874.78,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6755.99,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4406.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6241.95,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":477.33,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":2056.17,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":2056.17,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1982.74,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1395.26,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6241.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":5507.60,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":477.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":477.33,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":477.33,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3671.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6241.95,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3671.74,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1946.02,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3304.56,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1285.11,"methodology":"percent of total billed charges"}]}]},{"description":"XR FLUORO FOR SPINE INJ ","code_information":[{"code":"688874","type":"CDM"},{"code":"77003","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":4223.25,"discounted_cash":4223.25,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":215.39,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1098.05,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":380.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":971.35,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2111.63,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3378.60,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3885.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2533.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3589.76,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":274.51,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1182.51,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":1182.51,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1140.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":802.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3589.76,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3167.44,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":274.51,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":274.51,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":274.51,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2111.63,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3589.76,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2111.63,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1119.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1900.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":739.07,"methodology":"percent of total billed charges"}]}]},{"description":"XR FLUOROSCOPY 0-60 MIN ","code_information":[{"code":"683355","type":"CDM"},{"code":"76000","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":2006.69,"discounted_cash":2006.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":102.34,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":521.74,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":180.60,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":461.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1003.35,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1605.35,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1846.15,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1204.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1705.69,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":130.43,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":561.87,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":561.87,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":541.81,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":381.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1705.69,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1505.02,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":130.43,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":130.43,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":130.43,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1003.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1705.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1003.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":531.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":903.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":351.17,"methodology":"percent of total billed charges"}]}]},{"description":"XR HAND 3 + V RT ","code_information":[{"code":"680357","type":"CDM"},{"code":"73130","type":"CPT"}],"standard_charges":[{"modifiers":"RT","modifiers_description":"Right side (Used to identify procedures performed on the right side of the body)","setting":"outpatient","gross_charge":3028.10,"discounted_cash":3028.10,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":154.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":787.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":272.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":696.46,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1514.05,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2422.48,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2785.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1816.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2573.89,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":196.83,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":847.87,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":847.87,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":817.59,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":575.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2573.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2271.07,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":196.83,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":196.83,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":196.83,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1514.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2573.89,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1514.05,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":802.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1362.64,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":529.92,"methodology":"percent of total billed charges"}]}]},{"description":"XR HIP W PEL UN 2-3 VIEW ","code_information":[{"code":"716053","type":"CDM"},{"code":"73502","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":2214.23,"discounted_cash":2214.23,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":112.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":575.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":199.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":509.27,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1107.12,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1771.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2037.09,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1328.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1882.10,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":143.92,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":619.98,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":619.98,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":597.84,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":420.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1882.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1660.67,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":143.92,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":143.92,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":143.92,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1107.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1882.10,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1107.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":586.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":996.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":387.49,"methodology":"percent of total billed charges"}]}]},{"description":"XR RIBS UNI 2 V LT ","code_information":[{"code":"680279","type":"CDM"},{"code":"71100","type":"CPT"}],"standard_charges":[{"modifiers":"LT","modifiers_description":"Left side (Used to identify procedures performed on the left side of the body)","setting":"outpatient","gross_charge":738.08,"discounted_cash":738.08,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":37.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":191.90,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":66.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":169.76,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":369.04,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":590.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":679.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":442.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":627.37,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":206.66,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":206.66,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":199.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":140.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":627.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":553.56,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":369.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":627.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":369.04,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":195.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":332.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":129.16,"methodology":"percent of total billed charges"}]}]},{"description":"XR SCAPULA COMP RT ","code_information":[{"code":"680324","type":"CDM"},{"code":"73010","type":"CPT"}],"standard_charges":[{"modifiers":"RT","modifiers_description":"Right side (Used to identify procedures performed on the right side of the body)","setting":"outpatient","gross_charge":2372.81,"discounted_cash":2372.81,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":121.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":616.93,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":213.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":545.75,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1186.40,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1898.25,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2182.99,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1423.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2016.89,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":154.23,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":664.39,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":664.39,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":640.66,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":450.83,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2016.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1779.61,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":154.23,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":154.23,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":154.23,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1186.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2016.89,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1186.40,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":628.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1067.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":415.24,"methodology":"percent of total billed charges"}]}]},{"description":"XR SHOULDER 2 + V LT ","code_information":[{"code":"680327","type":"CDM"},{"code":"73030","type":"CPT"}],"standard_charges":[{"modifiers":"LT","modifiers_description":"Left side (Used to identify procedures performed on the left side of the body)","setting":"outpatient","gross_charge":3310.27,"discounted_cash":3310.27,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":168.82,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":860.67,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":297.92,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":761.36,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1655.13,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2648.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3045.45,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1986.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2813.73,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":215.17,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":926.88,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":926.88,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":893.77,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":628.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2813.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2482.70,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":215.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":215.17,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":215.17,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1655.13,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2813.73,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1655.13,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":877.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1489.62,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":579.30,"methodology":"percent of total billed charges"}]}]},{"description":"XR SPINE 1 V SPEC LEVEL ","code_information":[{"code":"680289","type":"CDM"},{"code":"72020","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":2587.35,"discounted_cash":2587.35,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":131.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":672.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":232.86,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":595.09,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1293.67,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2069.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2380.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1552.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2199.25,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":168.18,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":724.46,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":724.46,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":698.58,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":491.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2199.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1940.51,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":168.18,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":168.18,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":168.18,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1293.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2199.25,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1293.67,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":685.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1164.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":452.79,"methodology":"percent of total billed charges"}]}]},{"description":"XR SPINE 2 OR 3 VIEWS ","code_information":[{"code":"716059","type":"CDM"},{"code":"72082","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":1246.45,"discounted_cash":1246.45,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":63.57,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":324.08,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":112.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":286.68,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":623.23,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":997.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1146.73,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":747.87,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1059.48,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":81.02,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":349.01,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":349.01,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":336.54,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":236.83,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1059.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":934.84,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":81.02,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":81.02,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":81.02,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":623.23,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1059.48,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":623.23,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":330.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":560.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":218.13,"methodology":"percent of total billed charges"}]}]},{"description":"XR T-L-SPINE 2 VIEWS ","code_information":[{"code":"680299","type":"CDM"},{"code":"72080","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":738.08,"discounted_cash":738.08,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":37.64,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":191.90,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":66.43,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":169.76,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":369.04,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":590.46,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":679.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":442.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":627.37,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":206.66,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":206.66,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":199.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":140.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":627.37,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":553.56,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":47.98,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":369.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":627.37,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":369.04,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":195.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":332.14,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":129.16,"methodology":"percent of total billed charges"}]}]},{"description":"XRAY SM INTEST W MLT IMG ","code_information":[{"code":"718816","type":"CDM"},{"code":"74248","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":910.65,"discounted_cash":910.65,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":46.44,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":236.77,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":81.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":209.45,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":455.32,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":728.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":837.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":546.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":774.05,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":59.19,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":254.98,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":254.98,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":245.88,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":173.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":774.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":682.99,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":59.19,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":59.19,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":59.19,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":455.32,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":774.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":455.32,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":241.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":409.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":159.36,"methodology":"percent of total billed charges"}]}]},{"description":"ZAP-70 FC 1ST MARKER ","code_information":[{"code":"710897","type":"CDM"},{"code":"88184","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":123.18,"discounted_cash":123.18,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":6.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":32.03,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":11.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":28.33,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":61.59,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":98.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":113.33,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":73.91,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":104.70,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.01,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":34.49,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":34.49,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":33.26,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":23.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":104.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":92.39,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.01,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.01,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":8.01,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":16.01,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":61.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":104.70,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":61.59,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":32.64,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":55.43,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":21.56,"methodology":"percent of total billed charges"}]}]},{"description":"ZIMMERMAN PEROX AB ","code_information":[{"code":"704239","type":"CDM"},{"code":"88342","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":701.80,"discounted_cash":701.80,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":35.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":182.47,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":63.16,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":161.41,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":561.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":645.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":421.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":196.50,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":189.49,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":133.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":526.35,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":45.62,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":91.23,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":596.53,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":350.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":185.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":315.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":122.81,"methodology":"percent of total billed charges"}]}]},{"description":"ZINC PASTE BOOT UNNA ","code_information":[{"code":"971557","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":56.58,"discounted_cash":56.58,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":2.89,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":13.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":4.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":13.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":8.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":14.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":5.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":13.01,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":6.51,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.64,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":2.66,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":7.30,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":11.77,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":7.30,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":4.64,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":28.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":10.41,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":12.56,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":45.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":52.05,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":33.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":48.09,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.68,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":15.84,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":15.84,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":15.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":10.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":48.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":42.44,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.68,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.68,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":3.68,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":7.36,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":28.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":48.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":28.29,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":14.99,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":25.46,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":9.90,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":56.58,"methodology":"percent of total billed charges"}]}]},{"description":"ZONISAMIDE 50MG CAP ","code_information":[{"code":"688401","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4.24,"discounted_cash":4.24,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.22,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":1.01,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_percentage":8.10,"standard_charge_algorithm":"Reimbursement will be 8.1% of billable gross charges.","estimated_amount":0.34,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":23.80,"standard_charge_algorithm":"Reimbursement will be 23.8% of billable gross charges.","estimated_amount":1.01,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":14.30,"standard_charge_algorithm":"Reimbursement will be 14.3% of billable gross charges.","estimated_amount":0.61,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":0.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":0.98,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.35,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_percentage":11.50,"standard_charge_algorithm":"Reimbursement will be 11.5% of billable gross charges.","estimated_amount":0.49,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.35,"methodology":"percent of total billed charges"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_percentage":4.70,"standard_charge_algorithm":"Reimbursement will be 4.7% of billable gross charges.","estimated_amount":0.20,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":0.55,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_percentage":20.80,"standard_charge_algorithm":"Reimbursement will be 20.8% of billable gross charges.","estimated_amount":0.88,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_percentage":12.90,"standard_charge_algorithm":"Reimbursement will be 12.9% of billable gross charges.","estimated_amount":0.55,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_percentage":8.20,"standard_charge_algorithm":"Reimbursement will be 8.2% of billable gross charges.","estimated_amount":0.35,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2.12,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_percentage":18.40,"standard_charge_algorithm":"Reimbursement will be 18.4% of billable gross charges.","estimated_amount":0.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":22.20,"standard_charge_algorithm":"Reimbursement will be 22.2% of billable gross charges.","estimated_amount":0.94,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3.39,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3.60,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.28,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":1.14,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":0.81,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3.18,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.28,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.28,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.28,"methodology":"percent of total billed charges"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_percentage":13.00,"standard_charge_algorithm":"Reimbursement will be 13% of billable gross charges.","estimated_amount":0.55,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2.12,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2.12,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1.91,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":0.74,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_percentage":100.00,"standard_charge_algorithm":"Reimbursement will be 100% of billable gross charges.","estimated_amount":4.24,"methodology":"percent of total billed charges"}]}]},{"description":"ZONISAMIDE ZONEGRAN QN ","code_information":[{"code":"707657","type":"CDM"},{"code":"80203","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":8.00,"discounted_cash":8.00,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_percentage":5.10,"standard_charge_algorithm":"Reimbursement will be 5.1% of billable gross charges.","estimated_amount":0.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2.08,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":0.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1.84,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4.00,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":4.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6.80,"methodology":"percent of total billed charges"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.52,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":2.24,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_percentage":28.00,"standard_charge_algorithm":"Reimbursement will be 28% of billable gross charges.","estimated_amount":2.24,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_percentage":27.00,"standard_charge_algorithm":"Reimbursement will be 27% of billable gross charges.","estimated_amount":2.16,"methodology":"percent of total billed charges"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges not to exceed $3000.","estimated_amount":1.52,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":6.00,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.52,"methodology":"percent of total billed charges"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_percentage":6.50,"standard_charge_algorithm":"Reimbursement will be 6.5% of billable gross charges.","estimated_amount":0.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6.80,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4.00,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1.40,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 3.5MM 18MM ","code_information":[{"code":"997529","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2919.07,"discounted_cash":2919.07,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":758.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":262.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":671.39,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1459.54,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2335.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2685.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1751.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2481.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2481.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2189.30,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1459.54,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2481.21,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1459.54,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":773.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1313.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":510.84,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 3.5MM 26MM ","code_information":[{"code":"993850","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2034.82,"discounted_cash":2034.82,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":529.05,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":183.13,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":468.01,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1017.41,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1627.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1872.03,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1220.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1729.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1729.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1526.12,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1017.41,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1729.60,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1017.41,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":539.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":915.67,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":356.09,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 3MM 12MM ","code_information":[{"code":"997511","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2919.07,"discounted_cash":2919.07,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":758.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":262.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":671.39,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1459.54,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2335.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2685.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1751.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2481.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2481.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2189.30,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1459.54,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2481.21,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1459.54,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":773.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1313.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":510.84,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 3MM 15MM ","code_information":[{"code":"993849","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1137.30,"discounted_cash":1137.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":295.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":909.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1046.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":682.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":301.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.03,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 3MM 28MM ","code_information":[{"code":"511670","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":947.75,"discounted_cash":947.75,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":246.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":85.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":217.98,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":758.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":871.93,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":710.81,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":251.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":165.86,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 3MM 33MM ","code_information":[{"code":"511698","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":947.75,"discounted_cash":947.75,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":246.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":85.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":217.98,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":758.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":871.93,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":710.81,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":251.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":165.86,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 3MM 8MM ","code_information":[{"code":"511673","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":947.75,"discounted_cash":947.75,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":246.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":85.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":217.98,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":758.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":871.93,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":710.81,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":251.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":165.86,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 4.00MMX15MM ","code_information":[{"code":"519766","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1137.30,"discounted_cash":1137.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":295.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":909.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1046.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":682.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":301.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.03,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 4.00MMX18MM ","code_information":[{"code":"519835","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1137.30,"discounted_cash":1137.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":295.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":909.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1046.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":682.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":301.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.03,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 4.00MMX26MM ","code_information":[{"code":"519837","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1137.30,"discounted_cash":1137.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":295.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":909.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1046.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":682.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":301.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.03,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 4.00X12MM ","code_information":[{"code":"958986","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4928.30,"discounted_cash":4928.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1281.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":443.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1133.51,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3942.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4534.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2956.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3696.22,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1306.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2217.74,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":862.45,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 4.00X8MM ","code_information":[{"code":"958981","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4928.30,"discounted_cash":4928.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1281.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":443.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1133.51,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3942.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4534.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2956.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3696.22,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1306.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2217.74,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":862.45,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 4.50MMX22MM ","code_information":[{"code":"519844","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1137.30,"discounted_cash":1137.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":295.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":909.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1046.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":682.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":301.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.03,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 4.5MM 30MM ","code_information":[{"code":"994451","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2232.90,"discounted_cash":2232.90,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":580.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":200.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":513.57,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1116.45,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1786.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2054.27,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1339.74,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1897.96,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1897.96,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1674.67,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1116.45,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1897.96,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1116.45,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":591.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1004.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":390.76,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 4MM 23MM ","code_information":[{"code":"997490","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2919.07,"discounted_cash":2919.07,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":758.96,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":262.72,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":671.39,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1459.54,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2335.26,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2685.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1751.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2481.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2481.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2189.30,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1459.54,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2481.21,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1459.54,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":773.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1313.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":510.84,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 4MM 33MM ","code_information":[{"code":"511688","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":947.75,"discounted_cash":947.75,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":246.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":85.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":217.98,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":758.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":871.93,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":710.81,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":251.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":165.86,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 5.00MMX12MM ","code_information":[{"code":"519847","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1137.30,"discounted_cash":1137.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":295.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":102.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":909.84,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1046.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":682.38,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":966.71,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":301.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":511.79,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":199.03,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 5MM 12MM ","code_information":[{"code":"994474","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2502.06,"discounted_cash":2502.06,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":650.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":225.19,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":575.47,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1251.03,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2001.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2301.90,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1501.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2126.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2126.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1876.55,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1251.03,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2126.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1251.03,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":663.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1125.93,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":437.86,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR 5X33MM ","code_information":[{"code":"518628","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":947.75,"discounted_cash":947.75,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":246.41,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":85.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":217.98,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":758.20,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":871.93,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":568.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":710.81,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":805.59,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":473.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":251.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":426.49,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":165.86,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR OTW 2.25X24MM ","code_information":[{"code":"966397","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2236.69,"discounted_cash":2236.69,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":581.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":201.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":514.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.35,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1789.35,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2057.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1342.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1677.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":592.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1006.51,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":391.42,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR OTW 2.5X16MM ","code_information":[{"code":"966349","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1705.95,"discounted_cash":1705.95,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":443.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":153.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":392.37,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1569.47,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1023.57,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":452.08,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":767.68,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":298.54,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR OTW 2.5X28MM ","code_information":[{"code":"966405","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2236.69,"discounted_cash":2236.69,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":581.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":201.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":514.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.35,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1789.35,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2057.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1342.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1677.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":592.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1006.51,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":391.42,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR OTW 2.75X20MM ","code_information":[{"code":"966359","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1895.50,"discounted_cash":1895.50,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":492.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":170.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":435.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1743.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1137.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1421.63,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":502.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR OTW 2.75X26MM ","code_information":[{"code":"935750","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2331.47,"discounted_cash":2331.47,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":606.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":209.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":536.24,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1865.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2144.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1398.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1748.60,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":617.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1049.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":408.01,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR OTW 3.5X12MM ","code_information":[{"code":"966333","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1895.50,"discounted_cash":1895.50,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":492.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":170.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":435.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1743.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1137.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1421.63,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":502.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR OTW 3X24MM ","code_information":[{"code":"966400","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1895.50,"discounted_cash":1895.50,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":492.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":170.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":435.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1743.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1137.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1421.63,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":502.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR OTW 4X32MM ","code_information":[{"code":"966414","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2236.69,"discounted_cash":2236.69,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":581.54,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":201.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":514.44,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.35,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1789.35,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2057.75,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1342.01,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1677.52,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.35,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1901.19,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1118.35,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":592.72,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1006.51,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":391.42,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR OTW 4X8MM ","code_information":[{"code":"966328","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1895.50,"discounted_cash":1895.50,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":492.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":170.59,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":435.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1743.86,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1137.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1421.63,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":947.75,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":502.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":852.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":331.71,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR RX 2.25X8MM ","code_information":[{"code":"982717","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1232.08,"discounted_cash":1232.08,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":320.34,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":110.89,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":283.38,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":616.04,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":985.66,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":1133.51,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":739.25,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1047.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1047.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":924.06,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":616.04,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1047.27,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":616.04,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":326.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":554.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":215.61,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR RX 2.5X12MM ","code_information":[{"code":"884343","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2369.38,"discounted_cash":2369.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":616.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":213.24,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":544.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1895.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2179.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1421.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1777.04,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":627.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1066.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":414.64,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR RX 2.5X12MM ","code_information":[{"code":"982726","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3032.80,"discounted_cash":3032.80,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":788.53,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":272.95,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":697.54,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2426.24,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2790.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1819.68,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2577.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2577.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2274.60,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2577.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":803.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":530.74,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR RX 2.5X18MM ","code_information":[{"code":"884339","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2369.38,"discounted_cash":2369.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":616.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":213.24,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":544.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1895.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2179.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1421.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1777.04,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":627.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1066.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":414.64,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR RX 2.5X8MM ","code_information":[{"code":"884336","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2369.38,"discounted_cash":2369.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":616.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":213.24,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":544.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1895.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2179.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1421.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1777.04,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":627.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1066.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":414.64,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR RX 3X12MM ","code_information":[{"code":"873642","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2369.38,"discounted_cash":2369.38,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":616.04,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":213.24,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":544.96,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1895.50,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2179.83,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1421.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1777.04,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2013.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1184.69,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":627.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1066.22,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":414.64,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR RX 3X28MM ","code_information":[{"code":"982746","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2558.93,"discounted_cash":2558.93,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":665.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":230.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":588.55,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2047.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2354.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1535.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1919.20,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":678.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1151.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":447.81,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR RX2.25X38MM ","code_information":[{"code":"982724","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2558.93,"discounted_cash":2558.93,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":665.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":230.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":588.55,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2047.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2354.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1535.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1919.20,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":678.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1151.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":447.81,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR RX2.75X24MM ","code_information":[{"code":"982737","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2558.93,"discounted_cash":2558.93,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":665.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":230.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":588.55,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2047.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2354.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1535.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1919.20,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":678.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1151.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":447.81,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR RX3.00X38MM ","code_information":[{"code":"982748","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2558.93,"discounted_cash":2558.93,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":665.32,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":230.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":588.55,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2047.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2354.22,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1535.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1919.20,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2175.09,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1279.46,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":678.12,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1151.52,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":447.81,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR STRN 3.5X26MM ","code_information":[{"code":"935775","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2331.47,"discounted_cash":2331.47,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":606.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":209.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":536.24,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1865.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2144.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1398.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1748.60,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":617.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1049.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":408.01,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR STRN 3.5X30MM ","code_information":[{"code":"935777","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2331.47,"discounted_cash":2331.47,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":606.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":209.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":536.24,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1865.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2144.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1398.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1748.60,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":617.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1049.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":408.01,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR STRN 3X15MM ","code_information":[{"code":"935755","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2331.47,"discounted_cash":2331.47,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":606.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":209.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":536.24,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1865.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2144.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1398.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1748.60,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":617.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1049.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":408.01,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR STRN 3X9MM ","code_information":[{"code":"935751","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2331.47,"discounted_cash":2331.47,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":606.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":209.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":536.24,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1865.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2144.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1398.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1748.60,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":617.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1049.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":408.01,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR3.00X38MM ","code_information":[{"code":"958972","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4928.30,"discounted_cash":4928.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1281.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":443.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1133.51,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3942.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4534.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2956.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3696.22,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1306.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2217.74,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":862.45,"methodology":"percent of total billed charges"}]}]},{"description":"STENT COR4.00X32MM ","code_information":[{"code":"958991","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4928.30,"discounted_cash":4928.30,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1281.36,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":443.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1133.51,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3942.64,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":4534.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2956.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":3696.22,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4189.06,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":2464.15,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1306.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2217.74,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":862.45,"methodology":"percent of total billed charges"}]}]},{"description":"STENT ENDO 6FR 7X135CM ","code_information":[{"code":"529277","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12324.54,"discounted_cash":12324.54,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3204.38,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1109.21,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2834.64,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6162.27,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9859.63,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":11338.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":7394.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10475.86,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10475.86,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":9243.41,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6162.27,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10475.86,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6162.27,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3266.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5546.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2156.79,"methodology":"percent of total billed charges"}]}]},{"description":"STENT ENDO 7FR 135CM ","code_information":[{"code":"529278","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10842.26,"discounted_cash":10842.26,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2818.99,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":975.80,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2493.72,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5421.13,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8673.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":9974.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6505.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9215.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9215.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":8131.69,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5421.13,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9215.92,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5421.13,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2873.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4879.02,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1897.40,"methodology":"percent of total billed charges"}]}]},{"description":"STENT ENDOPROSTH 70X22MM ","code_information":[{"code":"806090","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3222.35,"discounted_cash":3222.35,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":837.81,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":290.01,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":741.14,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2577.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2964.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1933.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2739.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2739.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2416.76,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2739.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1611.17,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":853.92,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1450.06,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":563.91,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRS 9MMX59MM ","code_information":[{"code":"994117","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10121.97,"discounted_cash":10121.97,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2631.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":910.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2328.05,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5060.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8097.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":9312.21,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6073.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8603.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8603.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":7591.48,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5060.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8603.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5060.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2682.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4554.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1771.34,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRSTH 10X13X39MM ","code_information":[{"code":"994111","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10121.97,"discounted_cash":10121.97,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2631.71,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":910.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2328.05,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5060.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8097.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":9312.21,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6073.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8603.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8603.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":7591.48,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5060.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8603.67,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5060.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2682.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4554.89,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1771.34,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRSTH 5X8X15MM ","code_information":[{"code":"913349","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9178.01,"discounted_cash":9178.01,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2386.28,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":826.02,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2110.94,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4589.01,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7342.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":8443.77,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":5506.81,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7801.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7801.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":6883.51,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4589.01,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7801.31,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4589.01,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2432.17,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4130.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1606.15,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRSTH 5X8X79MM ","code_information":[{"code":"994121","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11505.69,"discounted_cash":11505.69,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2991.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1035.51,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2646.31,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5752.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9204.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":10585.23,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6903.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9779.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9779.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":8629.27,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5752.85,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9779.84,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5752.85,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3049.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5177.56,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2013.50,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRSTH 6CM 8-10MM ","code_information":[{"code":"990991","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16718.31,"discounted_cash":16718.31,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4346.76,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1504.65,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3845.21,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8359.16,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13374.65,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":15380.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":10030.99,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14210.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14210.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":12538.73,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8359.16,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14210.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8359.16,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4430.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7523.24,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2925.70,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRSTH 6X8X79MM ","code_information":[{"code":"988214","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11505.69,"discounted_cash":11505.69,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2991.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1035.51,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2646.31,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5752.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9204.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":10585.23,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6903.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9779.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9779.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":8629.27,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5752.85,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9779.84,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5752.85,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3049.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5177.56,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2013.50,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRSTH 7X11X79MM ","code_information":[{"code":"987307","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12081.92,"discounted_cash":12081.92,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3141.30,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1087.37,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2778.84,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6040.96,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9665.54,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":11115.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":7249.15,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10269.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10269.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":9061.44,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6040.96,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10269.63,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6040.96,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3201.71,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5436.86,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2114.34,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRSTH 8MM 10CM ","code_information":[{"code":"967007","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13298.83,"discounted_cash":13298.83,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3457.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1196.89,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3058.73,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6649.41,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10639.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":12234.92,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":7979.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11304.01,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11304.01,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":9974.12,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6649.41,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11304.01,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6649.41,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3524.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5984.47,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2327.30,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRSTH 8MM 7.5CM ","code_information":[{"code":"981734","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13101.70,"discounted_cash":13101.70,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":3406.44,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1179.15,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3013.39,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6550.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10481.36,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":12053.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":7861.02,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11136.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11136.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":9826.27,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6550.85,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11136.44,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":6550.85,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3471.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5895.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2292.80,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRSTH 8X11X79MM ","code_information":[{"code":"994124","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11505.69,"discounted_cash":11505.69,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2991.48,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1035.51,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2646.31,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5752.85,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9204.55,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":10585.23,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6903.41,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9779.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9779.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":8629.27,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5752.85,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9779.84,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5752.85,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3049.01,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5177.56,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2013.50,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRSTH 8X16X59MM ","code_information":[{"code":"990340","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10629.96,"discounted_cash":10629.96,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2763.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":956.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2444.89,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5314.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8503.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":9779.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6377.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9035.47,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9035.47,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":7972.47,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5314.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9035.47,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5314.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2816.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4783.48,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1860.24,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EPRSTH 9X13X39MM ","code_information":[{"code":"989544","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10629.96,"discounted_cash":10629.96,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2763.79,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":956.70,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2444.89,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5314.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8503.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":9779.56,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6377.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9035.47,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9035.47,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":7972.47,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5314.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9035.47,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5314.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2816.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4783.48,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1860.24,"methodology":"percent of total billed charges"}]}]},{"description":"STENT ESPH 18.5FR 18MM ","code_information":[{"code":"931269","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8529.75,"discounted_cash":8529.75,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2217.74,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":767.68,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1961.84,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4264.88,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7847.37,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":5117.85,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7250.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7250.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":6397.31,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4264.88,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7250.29,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4264.88,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2260.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3838.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1492.71,"methodology":"percent of total billed charges"}]}]},{"description":"STENT ESPH 18.5FR 23MM ","code_information":[{"code":"940326","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8340.20,"discounted_cash":8340.20,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2168.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":750.62,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1918.25,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4170.10,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6672.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":7672.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":5004.12,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7089.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7089.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":6255.15,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4170.10,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7089.17,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":4170.10,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":2210.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3753.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1459.54,"methodology":"percent of total billed charges"}]}]},{"description":"STENT EXPERT 4X20X135 ","code_information":[{"code":"898324","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6539.48,"discounted_cash":6539.48,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":1700.26,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":588.55,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":1504.08,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3269.74,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5231.58,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":6016.32,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":3923.69,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5558.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5558.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":4904.61,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3269.74,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5558.56,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":3269.74,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":1732.96,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2942.77,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1144.41,"methodology":"percent of total billed charges"}]}]},{"description":"STENT GENESIS AVIAT 5X18 ","code_information":[{"code":"803581","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3411.90,"discounted_cash":3411.90,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":887.09,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":307.07,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":784.74,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1705.95,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2729.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":3138.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":2047.14,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2900.11,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2900.11,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":2558.93,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1705.95,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2900.11,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1705.95,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":904.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1535.36,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":597.08,"methodology":"percent of total billed charges"}]}]},{"description":"STENT GRAFT 15X13X140MM ","code_information":[{"code":"515920","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17271.80,"discounted_cash":17271.80,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4490.67,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1554.46,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3972.51,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8635.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13817.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":15890.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":10363.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14681.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14681.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":12953.85,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8635.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14681.03,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8635.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4577.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7772.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3022.57,"methodology":"percent of total billed charges"}]}]},{"description":"STENT GRAFT 15X20X80MM ","code_information":[{"code":"515003","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17271.80,"discounted_cash":17271.80,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4490.67,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1554.46,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3972.51,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8635.90,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13817.44,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":15890.06,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":10363.08,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14681.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14681.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":12953.85,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8635.90,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14681.03,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":8635.90,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4577.03,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7772.31,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":3022.57,"methodology":"percent of total billed charges"}]}]},{"description":"STENT GRAFT 16X10X124MM ","code_information":[{"code":"950069","type":"CDM"},{"code":"C1874","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15599.97,"discounted_cash":15599.97,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":4055.99,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1404.00,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":3587.99,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7799.98,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12479.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":14351.97,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":9359.98,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13259.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13259.97,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":11699.98,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7799.98,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13259.97,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":7799.98,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":4133.99,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7019.99,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":2729.99,"methodology":"percent of total billed charges"}]}]},{"description":"STENT ILIAC LIMB OVAT 14 ","code_information":[{"code":"983410","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11373.00,"discounted_cash":11373.00,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":2956.98,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":1023.57,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":2615.79,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5686.50,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9098.40,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":10463.16,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":6823.80,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9667.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9667.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":8529.75,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5686.50,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9667.05,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":5686.50,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":3013.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5117.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":1990.28,"methodology":"percent of total billed charges"}]}]},{"description":"STENT NPHURET 8FR 28CM ","code_information":[{"code":"816342","type":"CDM"},{"code":"C2617","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":447.87,"discounted_cash":447.87,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":116.45,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":40.31,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":103.01,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":223.94,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":358.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":412.04,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":268.72,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":380.69,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":380.69,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":335.90,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":223.94,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":380.69,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":223.94,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":118.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":201.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":78.38,"methodology":"percent of total billed charges"}]}]},{"description":"STENT OTW 3MMX12MM ","code_information":[{"code":"874548","type":"CDM"},{"code":"C1876","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2331.47,"discounted_cash":2331.47,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":606.18,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":209.83,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":536.24,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1865.18,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":2144.95,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":1398.88,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":1748.60,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1981.75,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":1165.73,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":617.84,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1049.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":408.01,"methodology":"percent of total billed charges"}]}]},{"description":"STENT PGTL 8.5F 26CM ","code_information":[{"code":"968224","type":"CDM"},{"code":"C2617","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":648.15,"discounted_cash":648.15,"payers_information":[{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_percentage":26.00,"standard_charge_algorithm":"Reimbursement will be 26% of billable gross charges.","estimated_amount":168.52,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_percentage":9.00,"standard_charge_algorithm":"Reimbursement will be 9% of billable gross charges.","estimated_amount":58.33,"methodology":"percent of total billed charges"},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_percentage":23.00,"standard_charge_algorithm":"Reimbursement will be 23% of billable gross charges.","estimated_amount":149.07,"methodology":"percent of total billed charges"},{"payer_name":"Beacon Health Options","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":324.07,"methodology":"percent of total billed charges"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":518.52,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":596.30,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":388.89,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":550.93,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":550.93,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":486.11,"methodology":"percent of total billed charges"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":324.07,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":550.93,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":324.07,"methodology":"percent of total billed charges"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_percentage":26.50,"standard_charge_algorithm":"Reimbursement will be 26.5% of billable gross charges.","estimated_amount":171.76,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":291.67,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":17.50,"standard_charge_algorithm":"Reimbursement will be 17.5% of billable gross charges.","estimated_amount":113.43,"methodology":"percent of total billed charges"}]}]},{"description":"STENT THOR 20F 26X21X10 ","code_information":[{"code":"509405","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":51145.60,"discounted_cash":51145