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"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":7635.92,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7708.64,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":7272.30,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":7947.52,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":7272.30,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  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schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.39,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":21.88,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":20.23,"methodology":"fee schedule"},{"payer_name":"Solis Health Plan","plan_name":"MCR","standard_charge_dollar":26.67,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18.39,"methodology":"fee schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":18.39,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":18.76,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18.39,"methodology":"fee 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"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":10191.91,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10288.97,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":10968.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":9290.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":12943.58,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":9290.74,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":9803.65,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":9803.65,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":13676.84,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":32964.73,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":13676.84,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":9290.74,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":9747.73,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":9415.38,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":10677.24,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":15653.93,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":22700.87,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10483.11,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":9900.71,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10483.11,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":9803.65,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":10580.17,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8988.29,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9415.38,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":10288.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12133.23,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":9803.65,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":9803.65,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":9803.65,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":8732.37,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":10677.24,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":10191.91,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9706.58,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":9706.58,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":7804.22,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":9706.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":41012.04,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":44260.52,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":37601.14,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":39387.80,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":43042.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":50757.48,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":41012.04,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":41012.04,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":41012.04,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":40398.99,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":44666.58,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":42636.28,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":40605.98,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":40605.98,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":26452.12,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":40605.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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","code_information":[{"code":"80202","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":12.27,"maximum":19.63,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":13.54,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed 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"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":37917.17,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":16627.02,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":37917.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":109533.50,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":77489.37,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":109533.50,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":109533.50,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":109533.50,"methodology":"fee schedule"}]}]},{"description":"LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC ","code_information":[{"code":"824","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":66469.42,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":19420.47,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":19614.67,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":20974.11,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. 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"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":21945.13,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":18733.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":26099.18,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":18733.66,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19614.67,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19614.67,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":27577.70,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":66469.42,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":27577.70,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":18733.66,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":20860.36,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":18837.86,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":21362.52,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":33499.74,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":48580.34,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":20974.11,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":19808.88,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":20974.11,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":19614.67,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":21168.31,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":17983.36,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":18837.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. 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"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":19420.47,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":15736.28,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19420.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":23155.56,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":23376.08,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":24919.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":28861.88,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":40209.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":28861.88,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":22273.44,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":22273.44,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":42487.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":102405.62,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":42487.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":28861.88,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":23871.85,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":21391.32,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":24258.20,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":38335.90,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":55593.60,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":23817.14,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":22493.97,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":23817.14,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":22273.44,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":24037.67,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":20420.99,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":21391.32,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":23376.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":27566.14,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":22273.44,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":22273.44,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":22273.44,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":21385.25,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":24258.20,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":23155.56,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":22052.91,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":22052.91,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":24243.98,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":22052.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":21082.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":22052.91,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":22052.91,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":21611.85,"methodology":"fee schedule"}]}]},{"description":"MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC ","code_information":[{"code":"370","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":38264.54,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":6972.16,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7041.89,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":7529.94,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":7320.77,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7390.49,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":7878.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":10784.43,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":15024.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":10784.43,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":7041.89,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":7041.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":15875.69,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":38264.54,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":15875.69,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":10784.43,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":6619.58,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":6763.00,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7669.38,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":10630.41,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":15415.91,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":7529.94,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":7111.61,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7529.94,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":7041.89,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7599.66,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6456.22,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6763.00,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":7390.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8715.20,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":7041.89,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":7041.89,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":7041.89,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5930.06,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":7669.38,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":7320.77,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6972.16,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":6972.16,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":9058.92,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6972.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":6665.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6972.16,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":6972.16,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6832.72,"methodology":"fee schedule"}]}]},{"description":"MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO ","code_information":[{"code":"808","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":50592.65,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":20175.80,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":20377.56,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":21789.86,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":21184.59,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":21386.35,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":22798.65,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":12308.17,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":17147.38,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":12308.17,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":20377.56,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":20377.56,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":18118.78,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":43670.96,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":18118.78,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":12308.17,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":21724.44,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":19570.53,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":22193.38,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":34887.37,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":50592.65,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":21789.86,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":20579.32,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":21789.86,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":20377.56,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":21991.62,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":18682.79,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19570.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":21386.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":25219.75,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":20377.56,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":20377.56,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":20377.56,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":19461.53,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":22193.38,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":21184.59,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":20175.80,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":20175.80,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":10338.86,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":20175.80,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  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schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":432.00,"methodology":"fee schedule","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":416.29,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":412.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":400.58,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":400.58,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":447.71,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":432.00,"methodology":"fee schedule"},{"payer_name":"Cigna 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Plans","plan_name":"MCR","standard_charge_dollar":50.16,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":48.73,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":48.73,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":54.46,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":52.55,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":51.11,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":52.55,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":47.77,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":51.11,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of 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"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":17745.96,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":10303.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":14354.75,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":10303.66,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15861.43,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15861.43,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":15167.95,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":36558.70,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":15167.95,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":10303.66,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":16609.18,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":15233.26,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":17274.83,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":26672.76,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":38680.05,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16960.74,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":16018.48,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16960.74,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":15704.39,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":8655.07,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15704.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":19991.91,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":20182.30,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":21515.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":10817.39,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":15070.46,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":10817.39,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19230.31,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19230.31,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":15924.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":38381.47,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":15924.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":10817.39,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":20425.00,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":18468.71,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":20943.90,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":32800.59,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":47566.45,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":20563.10,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":19420.71,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":20563.10,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":19230.31,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":20753.50,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":17630.96,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":18468.71,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":20182.30,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":23799.89,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":19230.31,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":19230.31,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":19230.31,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":18297.44,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":20943.90,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":19991.91,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19039.91,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":19039.91,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":9086.61,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19039.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":18202.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":19039.91,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":19039.91,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18659.11,"methodology":"fee schedule"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC ","code_information":[{"code":"144","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":39956.63,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":15749.99,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15907.49,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":17009.99,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":16537.49,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16694.99,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":34636.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":16709.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":31803.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":17797.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":11261.33,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":15688.95,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":11261.33,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15907.49,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15907.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":16577.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":39956.63,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":16577.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":11261.33,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":16661.35,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":15277.49,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":17324.99,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":26756.53,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":38801.54,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":17009.99,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":16064.99,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":17009.99,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":15907.49,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":17167.49,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14584.49,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":15277.49,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":15749.99,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":9459.52,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15749.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":46367.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":54678.15,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":44179.95,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":44179.95,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":44179.95,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":43613.40,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":48116.77,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":45929.65,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":43742.52,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":43742.52,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":43742.52,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":42867.67,"methodology":"fee schedule"}]}]},{"description":"OTHER MALE REPRODUCTIVE SYSTEM O.R. 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"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":13082.09,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":14118.29,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":11994.07,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":12563.98,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. 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"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":12952.56,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":9130.57,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":12952.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":19076.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":10134.03,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":14118.43,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":10134.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17050.55,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17050.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":14918.24,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":35956.84,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":14918.24,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":10134.03,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":17956.05,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":16375.28,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":18569.90,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":28835.70,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":41816.69,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":18232.27,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":17219.36,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":18232.27,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":17050.55,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":18401.09,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":15632.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":16375.28,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":17894.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":21102.16,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":17050.55,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":17050.55,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":17050.55,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16085.67,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":18569.90,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":17725.82,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":16881.73,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":16881.73,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":8512.59,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":16881.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  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PROCEDURES FOR INJURIES WITH MCC ","code_information":[{"code":"907","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":87991.53,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":34213.52,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":34555.66,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":36950.60,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":35924.20,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":36266.33,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":38661.28,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":17586.01,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":24500.31,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":17586.01,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":34555.66,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":34555.66,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":25888.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":62397.41,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":25888.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":17586.01,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":37783.50,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":33187.11,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":37634.87,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":60676.67,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":87991.53,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":36950.60,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":34897.79,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":36950.60,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":34555.66,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":37292.74,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":31681.72,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":33187.11,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":36266.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":42766.90,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":34555.66,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":34555.66,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":34555.66,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":33847.80,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":37634.87,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":35924.20,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":34213.52,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":34213.52,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":14772.25,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":34213.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":34923.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":10554.71,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":14704.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":10554.71,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":31215.24,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":31215.24,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":15537.51,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":37449.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":15537.51,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":10554.71,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":33999.93,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":29978.99,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":33996.80,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":54600.63,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":79180.23,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":33378.67,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":31524.30,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":33378.67,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":31215.24,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":33687.74,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":28619.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":29978.99,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":32760.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":38632.72,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":31215.24,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":31215.24,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":31215.24,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":30458.35,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":33996.80,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":32451.49,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":30906.18,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":30906.18,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":8865.95,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":30906.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  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If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":30906.18,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":30906.18,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":30288.06,"methodology":"fee schedule"}]}]},{"description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems ","code_information":[{"code":"E0615","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New 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"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":25022.93,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":25261.24,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":24069.67,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":25976.18,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":22067.84,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":23116.42,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. 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"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":23831.36,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":24292.83,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":23831.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":27401.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":22782.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":20477.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":23831.36,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":23831.36,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":23354.73,"methodology":"fee schedule"}]}]},{"description":"ACUTE LEUKEMIA WITH MCC ","code_information":[{"code":"834","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":122083.69,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":47010.05,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":47480.15,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":50770.85,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":49360.55,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":49830.65,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":53121.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":22560.46,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":31430.56,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":22560.46,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":47480.15,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":47480.15,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":33211.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":80047.38,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":33211.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":22560.46,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":52422.65,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":45599.75,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":51711.06,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":84185.74,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":122083.69,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":50770.85,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":47950.25,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":50770.85,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":47480.15,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":51240.95,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":43531.31,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":45599.75,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. 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"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":49830.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":58762.56,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":47480.15,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":47480.15,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":47480.15,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":46962.07,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":51711.06,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":49360.55,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":47010.05,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":47010.05,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":18950.78,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":47010.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":19660.05,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":13283.29,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":18505.88,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":13283.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17572.25,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17572.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":19554.24,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":47130.80,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":19554.24,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":13283.29,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":18546.97,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":15832.43,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19138.10,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":29784.65,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":43192.83,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":18790.13,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":17746.24,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":18790.13,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":18442.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":21747.84,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":17572.25,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":17572.25,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":17572.25,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16615.03,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":19138.10,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":18268.18,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":17398.27,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":17398.27,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":11157.96,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":17398.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":27354.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":16632.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":20442.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17398.27,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":17398.27,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":17050.30,"methodology":"fee schedule"}]}]},{"description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad ","code_information":[{"code":"L1030","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":90.51,"maximum":135.30,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":93.31,"methodology":"fee schedule"},{"payer_name":"Align Senior 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multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":152.40,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":150.96,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":146.65,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":146.65,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":163.90,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":158.15,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":153.83,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":158.15,"methodology":"fee schedule"},{"payer_name":"Devoted 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Health","plan_name":"MCR","standard_charge_dollar":1538.63,"methodology":"fee schedule","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1482.68,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1426.73,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1426.73,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":1594.57,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1538.63,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1496.66,"methodology":"fee 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","code_information":[{"code":"L5677","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":560.57,"maximum":837.97,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":577.91,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":618.36,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":595.25,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":635.70,"methodology":"fee schedule","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":612.58,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":606.81,"methodology":"fee 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Care","plan_name":"MCR","standard_charge_dollar":6528.83,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":6347.47,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6407.93,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":6831.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":2792.55,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":3890.50,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":2792.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6105.67,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6105.67,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":4110.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":9908.34,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":4110.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":2792.55,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":5559.16,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":5863.86,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6649.74,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":8927.48,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":12946.36,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6528.83,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":6166.12,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6528.83,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":6105.67,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6589.28,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":5597.87,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":5863.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":6407.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":7556.52,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":6105.67,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":6105.67,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":6105.67,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":4980.09,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":6649.74,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":6347.47,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6045.21,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":6045.21,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":2345.74,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6045.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":5779.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6045.21,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":6045.21,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":5924.31,"methodology":"fee schedule"}]}]},{"description":"Albumin; urine (eg, microalbumin), quantitative ","code_information":[{"code":"82043","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":5.24,"maximum":8.38,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":5.78,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":6.18,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":5.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":6.36,"methodology":"fee schedule","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":6.13,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":6.07,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":5.90,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":5.90,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":7.23,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":6.59,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":6.36,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":6.18,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":6.36,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":5.78,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":6.18,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":6.30,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":5.78,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6.36,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6.07,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":5.24,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":5.78,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":6.88,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":6.36,"methodology":"fee schedule"},{"payer_name":"Solis Health Plan","plan_name":"MCR","standard_charge_dollar":8.38,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":5.78,"methodology":"fee schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":5.78,"methodology":"fee 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"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":16748.16,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16907.67,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8395.75,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":8395.75,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8227.84,"methodology":"fee schedule"}]}]},{"description":"Upper extremity addition, flexion/extension and rotation wrist unit ","code_information":[{"code":"L6624","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":4330.02,"maximum":6472.71,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":4463.94,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":4776.42,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":4597.86,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":4910.33,"methodology":"fee schedule","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":4731.78,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":4687.14,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":4553.22,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":4553.22,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":5088.89,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":4910.33,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":4776.42,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":4910.33,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":4463.94,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":4776.42,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":4865.69,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":4463.94,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":4910.33,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":4687.14,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":4330.02,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":4463.94,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":4910.33,"methodology":"fee schedule"},{"payer_name":"Solis Health Plan","plan_name":"MCR","standard_charge_dollar":6472.71,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":4463.94,"methodology":"fee schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":4463.94,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":4553.22,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":4463.94,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":4463.94,"methodology":"fee schedule"}]}]},{"description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design ","code_information":[{"code":"L6676","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":157.83,"maximum":235.93,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":162.71,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":174.10,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":167.59,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":178.98,"methodology":"fee schedule","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":172.47,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":170.85,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":165.96,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":165.96,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":185.49,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":178.98,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":174.10,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":178.98,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":162.71,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":174.10,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":177.35,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":162.71,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":178.98,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":170.85,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":157.83,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":162.71,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":178.98,"methodology":"fee schedule"},{"payer_name":"Solis Health Plan","plan_name":"MCR","standard_charge_dollar":235.93,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":162.71,"methodology":"fee schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":162.71,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":165.96,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":162.71,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":162.71,"methodology":"fee schedule"}]}]},{"description":"Upper extremity addition, removable insert, each ","code_information":[{"code":"L6691","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":393.90,"maximum":588.82,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":434.51,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":418.26,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":446.69,"methodology":"fee schedule","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":430.44,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":426.38,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":414.20,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":414.20,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":462.93,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":446.69,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":434.51,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":446.69,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":434.51,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of 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schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":414.20,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":406.08,"methodology":"fee schedule"}]}]},{"description":"Upper extremity addition, silicone gel insert or equal, each ","code_information":[{"code":"L6692","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":635.82,"maximum":950.45,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":655.48,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":701.36,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":675.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":721.03,"methodology":"fee schedule","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":694.81,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":688.25,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":668.59,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":668.59,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":747.25,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":721.03,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":701.36,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":721.03,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":655.48,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":701.36,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":714.47,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":655.48,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":721.03,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":688.25,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":635.82,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":655.48,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":721.03,"methodology":"fee schedule"},{"payer_name":"Solis Health Plan","plan_name":"MCR","standard_charge_dollar":950.45,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":655.48,"methodology":"fee schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":655.48,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":668.59,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":655.48,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":655.48,"methodology":"fee schedule"}]}]},{"description":"URETHRAL STRICTURE ","code_information":[{"code":"697","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":22128.76,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":9491.84,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":9586.76,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":10251.19,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":9966.43,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10061.35,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":10725.78,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":5756.67,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":8020.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":5756.67,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":9586.76,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":9586.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":8474.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":20425.41,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":8474.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":5756.67,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":9502.07,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":9207.08,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":10441.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":15259.42,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":22128.76,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10251.19,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":9681.68,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10251.19,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":9586.76,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":10346.11,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":8789.44,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":9207.08,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":10061.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":11864.80,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":9586.76,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":9586.76,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":9586.76,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":8512.29,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":10441.02,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":9966.43,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":9491.84,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":9491.84,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":4835.61,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":9491.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":9074.20,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":9491.84,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":9491.84,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":9302.00,"methodology":"fee schedule"}]}]},{"description":"VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC ","code_information":[{"code":"797","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":19297.35,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":9213.26,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_dollar":12346.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. 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"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":7735.20,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":8214.82,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":11444.64,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":8214.82,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6913.76,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6913.76,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":12092.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":29147.22,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":12092.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":8214.82,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":6474.46,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":6639.95,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7529.84,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":10397.36,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":15077.95,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":7392.93,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":6982.22,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7392.93,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":6913.76,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7461.39,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6338.76,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6639.95,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":7256.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8556.64,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":6913.76,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":6913.76,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":6913.76,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5800.05,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":7529.84,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":7187.57,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6845.31,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":6845.31,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":6900.45,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6845.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":6544.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":6845.31,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":6845.31,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":6708.40,"methodology":"fee schedule"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC ","code_information":[{"code":"143","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":72931.25,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":28560.62,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":28846.23,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":30845.47,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":29988.65,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":30274.26,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":34636.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":16709.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":31803.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":32273.50,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":11261.33,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":15688.95,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":11261.33,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":28846.23,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":28846.23,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":16577.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":39956.63,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":16577.72,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":11261.33,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":31316.62,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":27703.80,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":31416.68,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":50291.49,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":72931.25,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":30845.47,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":29131.83,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":30845.47,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":28846.23,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":31131.08,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":26447.13,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":27703.80,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":30274.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":35700.78,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":28846.23,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":28846.23,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":28846.23,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":28054.54,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":31416.68,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":29988.65,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":28560.62,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":28560.62,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":9459.52,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":28560.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":27303.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":28560.62,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":28560.62,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":27989.41,"methodology":"fee schedule"}]}]},{"description":"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC ","code_information":[{"code":"922","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":37312.74,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":15191.17,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15343.08,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16406.46,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":15950.73,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16102.64,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":17166.02,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":7850.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":10936.89,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":7850.36,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15343.08,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15343.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":11556.46,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":27854.08,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":11556.46,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":7850.36,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":16022.06,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":14735.43,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":16710.29,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":25729.89,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":37312.74,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16406.46,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":15494.99,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16406.46,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":15343.08,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16558.38,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14067.02,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14735.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":16102.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18988.96,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":15343.08,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":15343.08,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":15343.08,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":14353.13,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":16710.29,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":15950.73,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":15191.17,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":15191.17,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":6594.30,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15191.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":14522.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15191.17,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":15191.17,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":14887.35,"methodology":"fee schedule"}]}]},{"description":"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC ","code_information":[{"code":"566","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":24043.45,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":7387.55,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":7461.42,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":7978.55,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":7756.93,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7830.80,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":8347.93,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":6776.38,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":9440.65,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":6776.38,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":7461.42,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":7461.42,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":9975.46,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":24043.45,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":9975.46,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":6776.38,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":7094.78,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":7165.92,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":8126.30,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":11393.54,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":16522.57,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":7978.55,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":7535.30,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7978.55,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":7461.42,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":8052.43,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6840.87,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":7165.92,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":7830.80,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":9234.44,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":7461.42,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":7461.42,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":7461.42,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":6355.76,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":8126.30,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":7756.93,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":7387.55,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":7387.55,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":5692.16,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":7387.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":7062.50,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":7387.55,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":7387.55,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":7239.80,"methodology":"fee schedule"}]}]},{"description":"OTHER RESPIRATORY SYSTEM O.R. 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"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":37419.88,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":24875.15,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":34655.32,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":24875.15,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":33446.09,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":33446.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":36618.53,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":88260.19,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":36618.53,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":24875.15,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":36526.74,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":32121.49,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":36426.43,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":58658.43,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":85064.74,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":35764.14,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":33777.24,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":35764.14,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":33446.09,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":36095.28,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":30664.43,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":32121.49,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":35101.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":41393.68,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":33446.09,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":33446.09,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":33446.09,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":32721.95,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":36426.43,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":34770.69,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":33114.94,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":33114.94,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":20895.12,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":33114.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":31657.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":33114.94,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":33114.94,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":32452.64,"methodology":"fee schedule"}]}]},{"description":"Pain management (opioid-use disorder) genotyping panel, 16 common variants (ie, ABCB1, COMT, DAT1, DBH, DOR, DRD1, DRD2, DRD4, GABA, GAL, HTR2A, HTTLPR, MTHFR, MUOR, OPRK1, OPRM1), buccal swab or othe ","code_information":[{"code":"0078U","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":450.91,"maximum":653.82,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":450.91,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed 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"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":6985.60,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":7052.13,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":7517.84,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":7024.52,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":9786.35,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":7024.52,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":6719.48,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":6719.48,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":10340.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":24923.88,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":10340.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":7024.52,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":6254.41,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":6453.37,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":7318.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":10043.98,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":14565.49,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":7185.19,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":6786.01,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":7185.19,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":6719.48,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":7251.72,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":6160.64,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":6453.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":7052.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8316.19,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":6719.48,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":6719.48,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":6719.48,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":5602.92,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":7318.25,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":6985.60,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":6652.95,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":6652.95,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":5900.59,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":6652.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  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"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":13197.11,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13322.80,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":14202.61,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":6817.09,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":9497.36,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":6817.09,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":12694.37,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":12694.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":10035.39,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":24187.89,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":10035.39,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":6817.09,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":13021.96,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":12191.62,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":13825.55,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":20912.01,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":30325.99,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13574.17,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":12820.05,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13574.17,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":12694.37,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13699.86,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":11638.60,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":12191.62,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":13322.80,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":15710.85,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":12694.37,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":12694.37,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":12694.37,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":11665.53,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":13825.55,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":13197.11,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":12568.68,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":12568.68,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":5726.35,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":12568.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":12015.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12568.68,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":12568.68,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12317.31,"methodology":"fee schedule"}]}]},{"description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair ","code_information":[{"code":"K0056","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New equipment","setting":"outpatient","minimum":107.31,"maximum":160.41,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":110.63,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":118.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":113.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":121.69,"methodology":"fee schedule","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":117.27,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":116.16,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":112.84,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":112.84,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":126.12,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":121.69,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":118.37,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":121.69,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":110.63,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":118.37,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":120.59,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":110.63,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":121.69,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":116.16,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":107.31,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":110.63,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":121.69,"methodology":"fee schedule"},{"payer_name":"Solis Health Plan","plan_name":"MCR","standard_charge_dollar":160.41,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":110.63,"methodology":"fee schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":110.63,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":112.84,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":110.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":110.63,"methodology":"fee schedule"}]}]},{"description":"SEIZURES WITH MCC ","code_information":[{"code":"100","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":43851.08,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":17645.34,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":17821.79,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":19056.97,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":18527.61,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":18704.06,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":19939.23,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":7407.39,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":10319.76,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":7407.39,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":17821.79,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":17821.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":10904.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":26282.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":10904.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":7407.39,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":18829.62,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":17115.98,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19409.87,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":30238.57,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":43851.08,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19056.97,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":17998.25,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19056.97,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":17821.79,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":19233.42,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":16339.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":17115.98,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":18704.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":22056.67,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":17821.79,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":17821.79,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":17821.79,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":16868.24,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":19409.87,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":18527.61,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":17645.34,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":17645.34,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":6222.21,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":17645.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":16868.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":17645.34,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":17645.34,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":17292.43,"methodology":"fee schedule"}]}]},{"description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting ","code_information":[{"code":"L3967","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":2071.59,"maximum":3096.71,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":2135.66,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":2285.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":2199.73,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":2349.23,"methodology":"fee schedule","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":2263.80,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":2242.44,"methodology":"fee 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"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":20320.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":23962.60,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":19361.78,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":19361.78,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":19361.78,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":18430.84,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":21087.09,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":20128.58,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":19170.08,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":19170.08,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":11469.80,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19170.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":18326.60,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":19170.08,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":19170.08,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18786.68,"methodology":"fee schedule"}]}]},{"description":"NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC ","code_information":[{"code":"099","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":48448.01,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":12736.99,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":12864.36,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":13755.95,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":13373.84,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":13501.21,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":14392.80,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":13654.53,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":19023.08,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":13654.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":12864.36,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":12864.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":20100.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":48448.01,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":20100.74,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":13654.53,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":13214.50,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":12354.88,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":14010.69,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":21221.22,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":30774.39,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":13755.95,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":12991.73,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":13755.95,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":12864.36,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":13883.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":11794.45,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":12354.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":13501.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":15921.24,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":12864.36,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":12864.36,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":12864.36,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":11838.02,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":14010.69,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":13373.84,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":12736.99,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":12736.99,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":11469.80,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":12736.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":12176.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":12736.99,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":12736.99,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":12482.25,"methodology":"fee schedule"}]}]},{"description":"NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC ","code_information":[{"code":"988","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":60051.87,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":15413.37,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":15567.50,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":16646.44,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":16184.04,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":16338.17,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":17417.11,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":16924.95,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":23579.33,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":16924.95,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":15567.50,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":15567.50,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":24915.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":60051.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":24915.10,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":16924.95,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":16276.26,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":14950.97,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":16954.71,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":26138.11,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":37904.72,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":16646.44,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":15721.64,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":16646.44,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":15567.50,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":16800.57,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":14272.78,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":14950.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":16338.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":19266.71,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":15567.50,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":15567.50,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":15567.50,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":14580.85,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":16954.71,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":16184.04,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":15413.37,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":15413.37,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":14216.96,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":15413.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":14735.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":15413.37,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":15413.37,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":15105.10,"methodology":"fee schedule"}]}]},{"description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes 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"},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":8945.20,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":10548.58,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":8523.25,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":8523.25,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":8523.25,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":7433.18,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":9282.75,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":8860.81,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8438.86,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":8438.86,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":13410.89,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8438.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  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rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":9.06,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":8.98,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":8.72,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":8.72,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":9.75,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":9.41,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":9.15,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":9.41,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":9.15,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":9.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":9.41,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":8.98,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":8.29,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":9.41,"methodology":"fee schedule"},{"payer_name":"Solis Health Plan","plan_name":"MCR","standard_charge_dollar":12.40,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8.72,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8.55,"methodology":"fee schedule"}]}]},{"description":"OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC ","code_information":[{"code":"867","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":47363.23,"payers_information":[{"payer_name":"Access 2 Healthcare 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"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":19911.81,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":20101.45,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":21428.90,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":12799.61,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":17832.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":12799.61,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":19153.27,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":19153.27,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":18842.21,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":45414.64,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":18842.21,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":12799.61,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":20337.74,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":18394.72,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":20859.99,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":32660.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":47363.23,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":20480.72,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":19342.90,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":20480.72,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":19153.27,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":20670.36,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":17560.32,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":18394.72,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":13087.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":20101.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":23704.54,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":19153.27,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":19153.27,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":19153.27,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":18219.27,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":20859.99,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":19911.81,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18963.63,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":18963.63,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":10751.67,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":18963.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":18129.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18963.63,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":18963.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18584.36,"methodology":"fee schedule"}]}]},{"description":"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. 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"},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":23815.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":45326.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":30310.70,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":13465.52,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":18759.76,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":13465.52,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":27091.87,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":27091.87,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":19822.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":47777.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":19822.49,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":13465.52,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":29329.52,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":28164.81,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":29505.99,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":47100.39,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":68303.61,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":28969.52,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":27360.10,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":28969.52,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":27091.87,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":29237.76,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":27896.58,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":26018.92,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":28433.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":33529.54,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":27091.87,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":27091.87,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":27091.87,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":26274.42,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":29505.99,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":28164.81,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":26823.63,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":26823.63,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":11311.03,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":26823.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":55503.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":25643.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":41478.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":26823.63,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":26823.63,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":26287.16,"methodology":"fee schedule"}]}]},{"description":"Oxalate ","code_information":[{"code":"685973","type":"CDM"},{"code":"83945","type":"CPT"}],"standard_charges":[{"setting":"outpatient","minimum":13.09,"maximum":20.95,"gross_charge":9.00,"discounted_cash":9.00,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable 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"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":70652.07,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":71324.95,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":20274.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":10670.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":18616.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_percentage":35.00,"standard_charge_algorithm":"Reimbursement will be 35% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":56038.14,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":78070.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":56038.14,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":67960.57,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":67960.57,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":82493.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":198830.47,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":82493.37,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":56038.14,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":75620.11,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":65269.06,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":74016.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":121438.64,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":176106.76,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":72670.71,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":68633.44,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":72670.71,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":67960.57,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":73343.58,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":62308.40,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":65269.06,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. 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"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":8555.77,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":11509.00,"methodology":"case rate"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":8555.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":8179.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":8555.77,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":8555.77,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":8384.66,"methodology":"fee schedule"}]}]},{"description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each ","code_information":[{"code":"K0602","type":"HCPCS"}],"standard_charges":[{"modifiers":"NU","modifiers_description":"New 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HealthSpring","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.94,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":20.32,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":19.57,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.90,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":22.18,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":20.50,"methodology":"fee schedule"},{"payer_name":"Solis Health Plan","plan_name":"MCR","standard_charge_dollar":27.03,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":19.01,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":18.64,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":18.64,"methodology":"fee schedule"}]}]},{"description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard ","code_information":[{"code":"A6454","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1.04,"maximum":1.55,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1.07,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":1.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":1.10,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":1.18,"methodology":"fee schedule","additional_payer_notes":"Additional Notes: The rate (in dollars) may be further adjusted for multiple procedure logic."},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":1.13,"methodology":"fee schedule"},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":1.12,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":1.09,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":1.09,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":1.22,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":1.18,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":1.14,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":1.18,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":1.07,"methodology":"fee 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Plan","plan_name":"MCR","standard_charge_dollar":1.55,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1.07,"methodology":"fee schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":1.07,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1.09,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1.07,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1.07,"methodology":"fee schedule"}]}]},{"description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control ","code_information":[{"code":"L5724","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":1716.12,"maximum":2565.34,"payers_information":[{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":1769.20,"methodology":"fee 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schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":1946.12,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":1857.66,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":1716.12,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":1769.20,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":1946.12,"methodology":"fee schedule"},{"payer_name":"Solis Health Plan","plan_name":"MCR","standard_charge_dollar":2565.34,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":1769.20,"methodology":"fee schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":1769.20,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":1804.58,"methodology":"fee schedule"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":1769.20,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":1769.20,"methodology":"fee schedule"}]}]},{"description":"AICD LEAD PROCEDURES ","code_information":[{"code":"265","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":106639.27,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":30759.43,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":31067.02,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":33220.18,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":32297.40,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":32605.00,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":49364.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":25114.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":45326.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"Freedom Health Care","plan_name":"MCR","standard_charge_dollar":30536.95,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":32955.71,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":609.04,"methodology":"per diem"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":630.00,"methodology":"per diem"},{"payer_name":"Humana","plan_name":"HMO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":27997.24,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":29327.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"PPO","standard_charge_dollar":14906.00,"methodology":"case rate","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":32048.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":37793.25,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":30536.95,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":30536.95,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":30536.95,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":29770.09,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":33258.06,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":31746.33,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":30234.60,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":30234.60,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":13886.39,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":30234.60,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":28904.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":12500.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":30234.60,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":30234.60,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":29629.91,"methodology":"fee schedule"}]}]},{"description":"CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC ","code_information":[{"code":"433","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":609.04,"maximum":40118.27,"payers_information":[{"payer_name":"Access 2 Healthcare Physicians","plan_name":"MGMCR","standard_charge_dollar":10054.81,"methodology":"fee schedule"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":10155.36,"methodology":"fee schedule"},{"payer_name":"Align Senior Care","plan_name":"MCR","standard_charge_dollar":10859.19,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":10557.55,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":10658.10,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":14037.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":7387.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":12887.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":11361.94,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":11306.88,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":15752.42,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":11306.88,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":10155.36,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":10155.36,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":16644.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":40118.27,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":16644.79,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":11306.88,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":10146.10,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":9753.17,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":11060.29,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":16293.67,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":23628.60,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":10859.19,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":10255.91,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":10859.19,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. 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"},{"payer_name":"Molina","plan_name":"HIX","standard_charge_dollar":11098.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Molina","plan_name":"MGMCR","standard_charge_dollar":10658.10,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"COMPLEMENTARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"PRIMARYPPO","standard_charge_percentage":75.00,"standard_charge_algorithm":"Reimbursement will be 75% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":12568.51,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"MCRHMO","standard_charge_dollar":10155.36,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PFFS","standard_charge_dollar":10155.36,"methodology":"fee schedule"},{"payer_name":"Optimum  Healthcare","plan_name":"PPO","standard_charge_dollar":10155.36,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":9089.24,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":11060.29,"methodology":"fee schedule"},{"payer_name":"Plotkin Health","plan_name":"WORKERSCOMP","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health ","plan_name":"COMM","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Prime Health Sheriff","plan_name":"COMM","standard_charge_percentage":50.00,"standard_charge_algorithm":"Reimbursement will be 50% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Simply Healthcare","plan_name":"MGMCR","standard_charge_dollar":10557.55,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":10054.81,"methodology":"fee schedule"},{"payer_name":"Sunshine State Health Plan","plan_name":"QHP","standard_charge_dollar":10799.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":10054.81,"methodology":"fee schedule"},{"payer_name":"TRULI FOR HEALTH","plan_name":"COMM","standard_charge_dollar":9497.78,"methodology":"fee schedule"},{"payer_name":"Ultimate Health Plan","plan_name":"MCR","standard_charge_dollar":10054.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":12000.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $8618 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"GlobalBenefitPlanAppendix","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"MCR","standard_charge_dollar":9612.40,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"NarrowIndividualExchange","standard_charge_dollar":10000.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $345427.00, reimbursement will be $6447 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":27.10,"standard_charge_algorithm":"Reimbursement will be 27.1% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"United Behavioral Health","plan_name":"VACNN","standard_charge_dollar":10054.81,"methodology":"fee schedule"},{"payer_name":"United VA CCN","plan_name":"FED","standard_charge_dollar":10054.81,"methodology":"fee schedule"},{"payer_name":"WellMed","plan_name":"MGMCR","standard_charge_dollar":9853.71,"methodology":"fee schedule"}]}]},{"description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ","code_information":[{"code":"G0328","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","minimum":16.36,"maximum":26.17,"payers_information":[{"payer_name":"Aetna","plan_name":"GatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna ","plan_name":"MCR","standard_charge_dollar":18.05,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"NonGatedCOMM","standard_charge_percentage":11.60,"standard_charge_algorithm":"Reimbursement will be 11.6% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"QHP","standard_charge_percentage":6.90,"standard_charge_algorithm":"Reimbursement will be 6.9% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed 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","plan_name":"HIX","standard_charge_dollar":22.56,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":20.58,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":19.86,"methodology":"fee schedule"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":19.31,"methodology":"fee schedule"},{"payer_name":"Clear Spring Health","plan_name":"MCR","standard_charge_dollar":19.86,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":18.05,"methodology":"fee schedule"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":19.31,"methodology":"fee schedule"},{"payer_name":"Gold Kidney of Florida","plan_name":"Medicare","standard_charge_dollar":19.67,"methodology":"fee schedule"},{"payer_name":"Hernando-Pasco Hospice","plan_name":"COMM","standard_charge_dollar":18.05,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRHMO","standard_charge_dollar":19.86,"methodology":"fee schedule"},{"payer_name":"HUMANA","plan_name":"MGMCRPPO","standard_charge_dollar":18.95,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"TRICARE","standard_charge_dollar":16.36,"methodology":"fee schedule"},{"payer_name":"NDMS Definitive Care","plan_name":"MCR","standard_charge_dollar":18.05,"methodology":"fee schedule"},{"payer_name":"Oscar","plan_name":"HIX","standard_charge_dollar":21.48,"methodology":"fee schedule"},{"payer_name":"Pasco Sheriff's Office","plan_name":"MCR","standard_charge_dollar":19.86,"methodology":"fee schedule"},{"payer_name":"Solis Health Plan","plan_name":"MCR","standard_charge_dollar":26.17,"methodology":"fee schedule"},{"payer_name":"Sunshine State","plan_name":"MCR","standard_charge_dollar":18.05,"methodology":"fee schedule"},{"payer_name":"Swing Health","plan_name":"MCR","standard_charge_dollar":18.05,"methodology":"fee 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"},{"payer_name":"Alignment Health","plan_name":"MCR","standard_charge_dollar":40176.93,"methodology":"fee schedule"},{"payer_name":"American Health Plan","plan_name":"MCR","standard_charge_dollar":40559.56,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"ASOEO","standard_charge_dollar":74994.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"HIX","standard_charge_dollar":35719.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"AvMed","plan_name":"HMOFI","standard_charge_dollar":68861.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"BayCare Health Plans","plan_name":"MCR","standard_charge_dollar":43238.03,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"BSL","standard_charge_dollar":36940.99,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"HMO","standard_charge_dollar":51465.09,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MBN","standard_charge_dollar":36940.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"MCRPPO","standard_charge_dollar":38646.38,"methodology":"fee schedule"},{"payer_name":"BCBS ","plan_name":"MGMCRHMO","standard_charge_dollar":38646.38,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"NWB","standard_charge_dollar":54380.59,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PHS","standard_charge_dollar":131071.35,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"PPO","standard_charge_dollar":54380.59,"methodology":"fee schedule"},{"payer_name":"BCBS","plan_name":"SBN","standard_charge_dollar":36940.99,"methodology":"fee schedule"},{"payer_name":"Bright Health ","plan_name":"HIX","standard_charge_dollar":42416.92,"methodology":"fee schedule"},{"payer_name":"CarePlus","plan_name":"MGMCR","standard_charge_dollar":40176.93,"methodology":"fee schedule"},{"payer_name":"Centurion","plan_name":"LOGOV","standard_charge_dollar":42090.11,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"OAP","standard_charge_dollar":65457.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. 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"},{"payer_name":"Cigna HealthSpring","plan_name":"MCR","standard_charge_dollar":41324.84,"methodology":"fee schedule"},{"payer_name":"Devoted Health","plan_name":"MCR","standard_charge_dollar":39029.01,"methodology":"fee schedule"},{"payer_name":"Evernorth","plan_name":"BHCOMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"DISCOUNTPPO","standard_charge_percentage":92.00,"standard_charge_algorithm":"Reimbursement will be 92% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"SELECTPPO","standard_charge_percentage":60.00,"standard_charge_algorithm":"Reimbursement will be 60% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Evolutions","plan_name":"TRADITIONALPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Florida Complete Care","plan_name":"MCR","standard_charge_dollar":41324.84,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 6. 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