{"hospital_name":"LOS ROBLES HOSPITAL AND MEDICAL CENTER","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":["LOS ROBLES HOSPITAL AND MEDICAL CENTER","THOUSAND OAKS SURGICAL HOSPITAL"],"hospital_address":["215 WEST JANSS ROAD, THOUSAND OAKS, CA, 91360","401 ROLLING OAKS DR, THOUSAND OAKS, CA, 91361"],"license_information":{"hospital_license_number":"50000039","state":"CA"},"standard_charge_information":[{"description":"MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC ","code_information":[{"code":"435","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":39411.42,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":15308.66,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":19518.54,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":19518.54,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":19518.54,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":19518.54,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":19518.54,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":18753.10,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":39411.42,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":19518.54,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":25417.26,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":20092.61,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":22006.19,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":19135.82,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Mission HH Hospice","plan_name":"COMM","standard_charge_dollar":15308.66,"methodology":"fee schedule"},{"payer_name":"Multiplan ","plan_name":"COMPLEMENTARY","standard_charge_percentage":95.00,"standard_charge_algorithm":"Reimbursement will be 95% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"PRIMARY","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":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":25674.00,"methodology":"fee schedule"},{"payer_name":"PPO Next","plan_name":"PPO","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":19135.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":25674.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":15308.66,"methodology":"fee schedule"}]}]},{"description":"MALIGNANT BREAST DISORDERS WITH CC ","code_information":[{"code":"598","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":24079.25,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":9116.93,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":11624.08,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":11624.08,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":11624.08,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":11624.08,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":11624.08,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":11168.24,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":24079.25,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":11624.08,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":17314.11,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":11965.97,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":13105.58,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":11396.16,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Mission HH Hospice","plan_name":"COMM","standard_charge_dollar":9116.93,"methodology":"fee schedule"},{"payer_name":"Multiplan ","plan_name":"COMPLEMENTARY","standard_charge_percentage":95.00,"standard_charge_algorithm":"Reimbursement will be 95% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"PRIMARY","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":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":17489.00,"methodology":"fee schedule"},{"payer_name":"PPO Next","plan_name":"PPO","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":11396.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":17489.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":9116.93,"methodology":"fee schedule"}]}]},{"description":"MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC ","code_information":[{"code":"761","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":9359.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":5421.49,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":6912.40,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":6912.40,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":6912.40,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":6912.40,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":6912.40,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":6641.33,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":8156.83,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":6912.40,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":8746.65,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":7115.71,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":7793.39,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":6776.86,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Mission HH Hospice","plan_name":"COMM","standard_charge_dollar":5421.49,"methodology":"fee schedule"},{"payer_name":"Multiplan ","plan_name":"COMPLEMENTARY","standard_charge_percentage":95.00,"standard_charge_algorithm":"Reimbursement will be 95% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"PRIMARY","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":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":8835.00,"methodology":"fee schedule"},{"payer_name":"PPO Next","plan_name":"PPO","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":6776.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":8835.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":5421.49,"methodology":"fee schedule"}]}]},{"description":"MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC ","code_information":[{"code":"346","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":18787.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":10497.94,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":13384.88,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":13384.88,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":13384.88,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":13384.88,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":13384.88,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":12859.98,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":16005.21,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":13384.88,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":18599.13,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":13778.55,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":15090.79,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":13122.43,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Mission HH Hospice","plan_name":"COMM","standard_charge_dollar":10497.94,"methodology":"fee schedule"},{"payer_name":"Multiplan ","plan_name":"COMPLEMENTARY","standard_charge_percentage":95.00,"standard_charge_algorithm":"Reimbursement will be 95% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"PRIMARY","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":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":18787.00,"methodology":"fee schedule"},{"payer_name":"PPO Next","plan_name":"PPO","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":13122.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":14446.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":12914.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":22712.92,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":23848.57,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":6419.78,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":6740.76,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":10105.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":5825.91,"methodology":"fee schedule"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM WITH CC ","code_information":[{"code":"092","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":14969.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":11187.51,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":11187.51,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":11187.51,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":11187.51,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":8950.01,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":11411.26,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":11411.26,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":11411.26,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":11411.26,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":11411.26,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":10963.76,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":14336.81,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":11187.51,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":11411.26,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":11187.51,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":14819.31,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":11187.51,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":11187.51,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":11746.89,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":11187.51,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":12865.64,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":11187.51,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":18430.99,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":19352.54,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":6081.37,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":6385.44,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":22454.45,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":23577.17,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. 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If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":30524.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":17963.56,"methodology":"fee schedule"}]}]},{"description":"OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC ","code_information":[{"code":"673","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":53949.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":43690.76,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":43690.76,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":43690.76,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":43690.76,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":34952.61,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":44564.58,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":44564.58,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":44564.58,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":44564.58,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":44564.58,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":42816.94,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":44712.72,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":43690.76,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":44564.58,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":43690.76,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":53409.51,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":43690.76,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":12983.33,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":13632.50,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":16485.69,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":17309.97,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":16485.69,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":18958.54,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":16485.69,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":16485.69,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":16485.69,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":16485.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":21134.05,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":22190.75,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":21134.05,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":24304.16,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":21134.05,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":56545.90,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":59373.20,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 8. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":15780.86,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":16569.90,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. 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If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":20476.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":11839.93,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC ","code_information":[{"code":"177","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":25664.38,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":13581.35,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":17316.22,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":17316.22,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":17316.22,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":17316.22,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":17316.22,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":16637.16,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":25664.38,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":17316.22,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":24500.52,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":17825.52,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":19523.19,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":16976.69,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":16976.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":10744.27,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":11281.48,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":29864.01,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":34343.61,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":29864.01,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":29864.01,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":29864.01,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":29864.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":31202.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":27728.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":39690.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":23891.21,"methodology":"fee schedule"}]}]},{"description":"SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC ","code_information":[{"code":"195","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":9359.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":5329.31,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":6794.87,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":6794.87,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":6794.87,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":6794.87,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":6794.87,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":6528.41,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":9254.11,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":6794.87,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":9034.74,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":6994.72,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":7660.89,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":6661.64,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":6661.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":17581.87,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":18460.96,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. 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"},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":45016.34,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":51768.79,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":45016.34,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":11652.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":6802.50,"methodology":"fee schedule"}]}]},{"description":"TRAUMATIC INJURY WITH MCC ","code_information":[{"code":"913","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":21831.81,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":16994.33,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":16994.33,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":16994.33,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":16994.33,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":13595.46,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":17334.22,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":17334.22,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":17334.22,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":17334.22,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":17334.22,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":16654.44,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":21831.81,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":16994.33,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":17334.22,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":16994.33,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":21584.97,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":16994.33,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":16994.33,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":17844.05,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":65072.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":41703.22,"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":1145.00,"maximum":14457.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":9455.02,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":9455.02,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":9455.02,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":9455.02,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":7564.01,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":9644.12,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":9644.12,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":9644.12,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":9644.12,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":9644.12,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":9265.92,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":13420.21,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":9455.02,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":9644.12,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":9455.02,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":14312.43,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":9455.02,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":9455.02,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":9927.77,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":26070.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":15256.34,"methodology":"fee schedule"}]}]},{"description":"VAGINAL DELIVERY WITH O.R. 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"},{"payer_name":"Mission HH Hospice","plan_name":"COMM","standard_charge_dollar":9261.42,"methodology":"fee schedule"},{"payer_name":"Multiplan ","plan_name":"COMPLEMENTARY","standard_charge_percentage":95.00,"standard_charge_algorithm":"Reimbursement will be 95% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"PRIMARY","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":17770.00,"methodology":"fee schedule"},{"payer_name":"PPO Next","plan_name":"PPO","standard_charge_dollar":1958.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":1958.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. 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If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":21461.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":12056.67,"methodology":"fee schedule"}]}]},{"description":"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY ","code_information":[{"code":"895","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":23470.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":15226.54,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":15226.54,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":15226.54,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":15226.54,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":12181.23,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":15531.07,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":15531.07,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":15531.07,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":15531.07,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":15531.07,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":14922.01,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":22474.90,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":15226.54,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":15531.07,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":15226.54,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":23235.30,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":15226.54,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":15226.54,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":15987.87,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":15226.54,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":15226.54,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":15226.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":23470.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":12181.23,"methodology":"fee schedule"}]}]},{"description":"AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC ","code_information":[{"code":"239","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":70125.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":41982.24,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":53527.36,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":53527.36,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":53527.36,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":53527.36,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":53527.36,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":51428.24,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":59507.33,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":53527.36,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":69423.75,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":55101.69,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 11. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":60349.47,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":52477.80,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 11. "},{"payer_name":"Mission HH Hospice","plan_name":"COMM","standard_charge_dollar":41982.24,"methodology":"fee schedule"},{"payer_name":"Multiplan ","plan_name":"COMPLEMENTARY","standard_charge_percentage":95.00,"standard_charge_algorithm":"Reimbursement will be 95% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"PRIMARY","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":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":70125.00,"methodology":"fee schedule"},{"payer_name":"PPO Next","plan_name":"PPO","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":52477.80,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":14446.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":12914.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":70125.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":41982.24,"methodology":"fee schedule"}]}]},{"description":"ANAL AND STOMAL PROCEDURES WITH CC ","code_information":[{"code":"348","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":18985.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":10610.88,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":13528.87,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":13528.87,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":13528.87,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":13528.87,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":13528.87,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":12998.33,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":17672.66,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":13528.87,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":18795.15,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":13926.78,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":15253.14,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":13263.60,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Mission HH Hospice","plan_name":"COMM","standard_charge_dollar":10610.88,"methodology":"fee schedule"},{"payer_name":"Multiplan ","plan_name":"COMPLEMENTARY","standard_charge_percentage":95.00,"standard_charge_algorithm":"Reimbursement will be 95% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"PRIMARY","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":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":18985.00,"methodology":"fee schedule"},{"payer_name":"PPO Next","plan_name":"PPO","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":13263.60,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":14446.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":12914.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":18985.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":10610.88,"methodology":"fee schedule"}]}]},{"description":"APPENDIX PROCEDURES WITHOUT CC/MCC ","code_information":[{"code":"399","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":16238.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":11865.36,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":11865.36,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":11865.36,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":11865.36,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":9492.29,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":12102.67,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":12102.67,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":12102.67,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":12102.67,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":12102.67,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":11628.05,"methodology":"fee schedule"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":11865.36,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":12102.67,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":11865.36,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":16075.62,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":11865.36,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":11865.36,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":12458.63,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. 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If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":16238.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":9492.29,"methodology":"fee schedule"}]}]},{"description":"BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC ","code_information":[{"code":"520","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":33452.00,"payers_information":[{"payer_name":"Aetna","plan_name":"EPO","standard_charge_dollar":30407.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":15072.91,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":12058.33,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":15374.37,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":15374.37,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":15374.37,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":15374.37,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":15374.37,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":14771.45,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":18937.00,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":15072.91,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":15374.37,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":15072.91,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_dollar":16740.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":15072.91,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":15072.91,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":15072.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":32162.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":28581.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":20883.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":12058.33,"methodology":"fee schedule"}]}]},{"description":"BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC ","code_information":[{"code":"462","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":85866.00,"payers_information":[{"payer_name":"Aetna","plan_name":"EPO","standard_charge_dollar":69944.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Aetna","plan_name":"HMO","standard_charge_dollar":69944.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_dollar":70466.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"Anthem","plan_name":"COMM","standard_charge_dollar":45229.00,"methodology":"case rate"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":23937.71,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":30520.58,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":30520.58,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":30520.58,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":30520.58,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":30520.58,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":29323.70,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":38206.72,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":30520.58,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_dollar":27873.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":27873.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":41108.76,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"COMM","standard_charge_dollar":23276.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":31418.25,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":34410.46,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":29922.14,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Mission HH Hospice","plan_name":"COMM","standard_charge_dollar":23937.71,"methodology":"fee schedule"},{"payer_name":"Multiplan ","plan_name":"COMPLEMENTARY","standard_charge_percentage":95.00,"standard_charge_algorithm":"Reimbursement will be 95% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"PRIMARY","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":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":41524.00,"methodology":"fee schedule"},{"payer_name":"PPO Next","plan_name":"PPO","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":29922.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":85866.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":76307.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":41524.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":23937.71,"methodology":"fee schedule"}]}]},{"description":"BONE DISEASES AND ARTHROPATHIES WITHOUT MCC ","code_information":[{"code":"554","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":11989.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":8860.22,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":8860.22,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":8860.22,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":8860.22,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":7088.18,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":9037.42,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":9037.42,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":9037.42,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":9037.42,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":9037.42,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":8683.01,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":11826.46,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":8860.22,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":9037.42,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":8860.22,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":11869.11,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":8860.22,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":8860.22,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":9303.23,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":8860.22,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":10189.25,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":8860.22,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":7870.96,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":8264.51,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":29318.00,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":29318.00,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":29318.00,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":23220.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":20635.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":39515.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":23454.40,"methodology":"fee schedule"}]}]},{"description":"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER ","code_information":[{"code":"219","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":48500.00,"maximum":174511.00,"payers_information":[{"payer_name":"Aetna","plan_name":"EPO","standard_charge_dollar":98270.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Aetna","plan_name":"HMO","standard_charge_dollar":98270.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":80510.20,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_dollar":101121.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":80510.20,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":80510.20,"methodology":"fee schedule"},{"payer_name":"Anthem","plan_name":"COMM","standard_charge_dollar":123288.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 10. 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"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":53774.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. 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"},{"payer_name":"Health Net","plan_name":"WorkersComp","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":80510.20,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":84535.71,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 8. 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"},{"payer_name":"Mission HH Hospice","plan_name":"COMM","standard_charge_dollar":64408.16,"methodology":"fee schedule"},{"payer_name":"Multiplan ","plan_name":"COMPLEMENTARY","standard_charge_percentage":95.00,"standard_charge_algorithm":"Reimbursement will be 95% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"PRIMARY","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_dollar":48500.00,"methodology":"case rate"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":112497.00,"methodology":"fee schedule"},{"payer_name":"PPO Next","plan_name":"PPO","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":"PPO Next","plan_name":"WC","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":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":80510.20,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":80510.20,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":80510.20,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":174511.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 10. "},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":155083.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 10. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":17193.64,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":18053.32,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":17193.64,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":19772.69,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":17193.64,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. 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If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":24903.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":13754.91,"methodology":"fee schedule"}]}]},{"description":"DIGESTIVE MALIGNANCY WITHOUT CC/MCC ","code_information":[{"code":"376","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":19789.12,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":9361.59,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":9361.59,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":9361.59,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":9361.59,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":7489.28,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":9548.83,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":9548.83,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":9548.83,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":9548.83,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":9548.83,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":9174.36,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":19789.12,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":9361.59,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":9548.83,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":9361.59,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":12873.96,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":9361.59,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":10924.89,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":11471.13,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":8296.56,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":8711.39,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":46910.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":26566.87,"methodology":"fee schedule"}]}]},{"description":"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC ","code_information":[{"code":"513","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":23648.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":15824.46,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":15824.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":15824.46,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":15824.46,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":12659.57,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":16140.95,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":16140.95,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":16140.95,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":16140.95,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":16140.95,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":15507.97,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":20398.42,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":15824.46,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":16140.95,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":15824.46,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":23411.52,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":15824.46,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":15824.46,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":16615.68,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":12971.91,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":13620.51,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":16050.75,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":16853.29,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":13982.97,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":14682.12,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":15377.06,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":16145.91,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":15377.06,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":17683.62,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":15377.06,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":37408.52,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":39278.95,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 8. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":37408.52,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":43019.80,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":37408.52,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 8. "},{"payer_name":"Mission HH Hospice","plan_name":"COMM","standard_charge_dollar":29926.82,"methodology":"fee schedule"},{"payer_name":"Multiplan ","plan_name":"COMPLEMENTARY","standard_charge_percentage":95.00,"standard_charge_algorithm":"Reimbursement will be 95% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"PRIMARY","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":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":53058.00,"methodology":"fee schedule"},{"payer_name":"PPO Next","plan_name":"PPO","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":37408.52,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":37408.52,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":37408.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":53058.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":29926.82,"methodology":"fee schedule"}]}]},{"description":"NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC ","code_information":[{"code":"071","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":15490.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":8908.49,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":11358.32,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":11358.32,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":11358.32,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":11358.32,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":11358.32,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":10912.90,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":15413.91,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":11358.32,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":15335.10,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":11692.39,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":12805.95,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":11135.61,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":11135.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":16773.23,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":16773.23,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":16773.23,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":13418.58,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":17108.69,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":17108.69,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":17108.69,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":17108.69,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":17108.69,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":16437.77,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":21570.62,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":16773.23,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":17108.69,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":16773.23,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_dollar":38456.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":7665.43,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":8048.70,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":7665.43,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":8815.24,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":7665.43,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":16444.17,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":17266.38,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":41547.20,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":43624.56,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. 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If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":10455.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":6081.69,"methodology":"fee schedule"}]}]},{"description":"PULMONARY EDEMA AND RESPIRATORY FAILURE ","code_information":[{"code":"189","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":17973.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":10434.00,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":13303.35,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":13303.35,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":13303.35,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":13303.35,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":13303.35,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":12781.65,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":17403.73,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":13303.35,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":17793.27,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":13694.63,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":14998.87,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":13042.50,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":13042.50,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":17973.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":10434.00,"methodology":"fee schedule"}]}]},{"description":"RED BLOOD CELL DISORDERS WITHOUT MCC ","code_information":[{"code":"812","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":13140.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":7821.45,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":9972.35,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":9972.35,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":9972.35,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":9972.35,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":9972.35,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":9581.28,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":12948.26,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":9972.35,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":13008.60,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":10265.65,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":11243.33,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":9776.81,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Mission HH Hospice","plan_name":"COMM","standard_charge_dollar":7821.45,"methodology":"fee schedule"},{"payer_name":"Multiplan ","plan_name":"COMPLEMENTARY","standard_charge_percentage":95.00,"standard_charge_algorithm":"Reimbursement will be 95% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"PRIMARY","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":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":13140.00,"methodology":"fee schedule"},{"payer_name":"PPO Next","plan_name":"PPO","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":9776.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":13140.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":7821.45,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC ","code_information":[{"code":"179","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":11324.68,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":6549.22,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":8350.26,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":8350.26,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":8350.26,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":8350.26,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":8350.26,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":8022.80,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":11324.68,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":8350.26,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":11023.65,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":8595.85,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":9414.51,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":8186.53,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":8186.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":11135.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":6549.22,"methodology":"fee schedule"}]}]},{"description":"RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC ","code_information":[{"code":"814","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":31046.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":21894.94,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":21894.94,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":21894.94,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":21894.94,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":17515.95,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":22332.84,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":22332.84,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":22332.84,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":22332.84,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":22332.84,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":21457.04,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":27094.74,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":21894.94,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":22332.84,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":21894.94,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":30735.54,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":21894.94,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":21894.94,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":22989.69,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":21894.94,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":25179.18,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":21894.94,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":18724.75,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":19660.99,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. 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"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":50013.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":28030.93,"methodology":"fee schedule"}]}]},{"description":"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC ","code_information":[{"code":"327","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":36434.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":25401.46,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":25401.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":25401.46,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":25401.46,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":20321.17,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":25909.49,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":25909.49,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":25909.49,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":25909.49,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":25909.49,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":24893.43,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":32776.96,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":25401.46,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":25909.49,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":25401.46,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":36069.66,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":25401.46,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":25401.46,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":25401.46,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":25401.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":14446.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":12914.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":16260.44,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":17073.46,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":9708.30,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":10193.72,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":33457.72,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":35130.61,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":1958.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":24763.06,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":26001.21,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":18429.95,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":19351.45,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":21448.58,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":22521.01,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":27231.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":14753.10,"methodology":"fee schedule"}]}]},{"description":"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER ","code_information":[{"code":"220","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":44139.71,"maximum":164532.00,"payers_information":[{"payer_name":"Aetna","plan_name":"EPO","standard_charge_dollar":98270.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Aetna","plan_name":"HMO","standard_charge_dollar":98270.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":55174.64,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_dollar":101121.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":55174.64,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":55174.64,"methodology":"fee schedule"},{"payer_name":"Anthem","plan_name":"COMM","standard_charge_dollar":123288.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 10. 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"},{"payer_name":"Health Net","plan_name":"WorkersComp","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":55174.64,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":57933.37,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. 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"},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":146216.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 10. 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"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":51528.10,"methodology":"fee schedule"}]}]},{"description":"CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC ","code_information":[{"code":"234","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":44335.70,"maximum":123288.00,"payers_information":[{"payer_name":"Aetna","plan_name":"EPO","standard_charge_dollar":84286.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. 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"},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":95484.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 9. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":20479.05,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":21503.00,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":7043.64,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":7395.82,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":7043.64,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":7043.64,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":7043.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":9359.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462016.00, reimbursement will be $11568 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":8536.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":10226.29,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":10737.60,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":17400.21,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":18270.22,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. 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"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":22593.78,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":16088.12,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":16088.12,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":16892.53,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":10777.49,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":11316.36,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":10498.25,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":11023.16,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":11393.05,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":11962.70,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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If billable gross charges exceed threshold of $462016.00, reimbursement will be $10280 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":17483.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":9114.44,"methodology":"fee schedule"}]}]},{"description":"KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC ","code_information":[{"code":"659","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":52559.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":21617.47,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":27562.28,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":27562.28,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":27562.28,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":27562.28,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":27562.28,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":26481.40,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":32976.59,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":27562.28,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":37391.31,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":28372.93,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Interplan Corporation ","plan_name":"COMM","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Interplan Corporation ","plan_name":"WC","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"LA Care ","plan_name":"DSNP","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"Los Angeles Rams","plan_name":"COMM","standard_charge_dollar":31075.12,"methodology":"fee schedule"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":27021.84,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. 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"},{"payer_name":"PPO Next","plan_name":"WC","standard_charge_dollar":2222.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"Tender Loving Care","plan_name":"COMM","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":27021.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":52559.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 8. "},{"payer_name":"United","plan_name":"NationalAccount","standard_charge_dollar":46707.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 8. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":31.10,"standard_charge_algorithm":"Reimbursement will be 31.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"COMM","standard_charge_percentage":70.00,"standard_charge_algorithm":"Reimbursement will be 70% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Ventura County Foundation ","plan_name":"WCOMP","standard_charge_dollar":37769.00,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare","plan_name":"COMM","standard_charge_dollar":21617.47,"methodology":"fee schedule"}]}]},{"description":"KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC ","code_information":[{"code":"696","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1145.00,"maximum":10096.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCR","standard_charge_dollar":7376.85,"methodology":"fee schedule"},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":7376.85,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":7376.85,"methodology":"fee schedule"},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":7376.85,"methodology":"fee schedule"},{"payer_name":"Assisted Hospice Care","plan_name":"COMM","standard_charge_dollar":5901.48,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRHMO","standard_charge_dollar":7524.39,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPOS","standard_charge_dollar":7524.39,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRPPO","standard_charge_dollar":7524.39,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"MCRSNP","standard_charge_dollar":7524.39,"methodology":"fee schedule"},{"payer_name":"Blue Shield","plan_name":"PFFS","standard_charge_dollar":7524.39,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":7229.32,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":9992.37,"methodology":"case rate"},{"payer_name":"Buena Vista Hospice","plan_name":"COMM","standard_charge_dollar":7376.85,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":7524.39,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":7376.85,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":9995.04,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":7376.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"COMM","standard_charge_dollar":3785.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health","plan_name":"WCOMP","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":"Health Net","plan_name":"WorkersComp","standard_charge_dollar":1145.00,"methodology":"per diem"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":7376.85,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":7745.70,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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